The augmented role of pancreatic imaging in the era of endoscopic necrosectomy: an illustrative and pictorial review

Harit Kapoor, Mohamed Issa, Michael A. Winkler, Rashmi T. Nair, Frandah Wesam, Halemane Ganesh

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations

Abstract

Endoscopic cystogastrostomy for mature pancreatic collections has long been recognized. However, FDA approval of newer lumen-apposing metallic stents in 2014 has now brought pancreatic necrosectomy to the endoscopic realm. Endoscopic drainage of Walled-off necrosis and direct endoscopic necrosectomy are technically challenging procedures with higher rates of complications. Collaborative clinical decision making both pre- and post-procedurally between the radiologist, endoscopist, and the surgeon can greatly improve outcomes in necrotizing pancreatitis. Herein, we review the basic pathophysiology that underlies progressive radiographic findings in NP, value of preprocedural imaging, current management algorithms, newer tools, and techniques as well as potential post-procedure complications on imaging follow-up after endoscopic interventions in necrotizing pancreatitis.

Original languageEnglish (US)
Pages (from-to)1534-1549
Number of pages16
JournalAbdominal Radiology
Volume45
Issue number5
DOIs
StatePublished - May 1 2020
Externally publishedYes

Keywords

  • DEN
  • Endoscopic necrosectomy
  • LAMS
  • Necrotizing pancreatitis
  • Transmural drainage

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology
  • Urology

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