Theme |
Role of Endoscopy in the Diagnosis and Treatments of Pancreatic Diseases |
Title |
Endoscopic Treatment for Pancreatic Pseudocysts |
Author |
Atsushi Irisawa |
Department of Internal Medicine II, Fukushima Medical University |
Author |
Goro Shibukawa |
Department of Internal Medicine II, Fukushima Medical University |
Author |
Takuto Hikichi |
Department of Endoscopy Fukashima Medical University Hospital |
Author |
Tadayuki Takagi |
Department of Internal Medicine II, Fukushima Medical University |
Author |
Takeru Wakatsuki |
Department of Internal Medicine II, Fukushima Medical University |
Author |
Hidemichi Imamura |
Department of Internal Medicine II, Fukushima Medical University |
Author |
Yuta Takahashi |
Department of Internal Medicine II, Fukushima Medical University |
Author |
Ai Sato |
Department of Internal Medicine II, Fukushima Medical University |
Author |
Masaki Sato |
Department of Internal Medicine II, Fukushima Medical University |
Author |
Tsunehiko Ikeda |
Department of Internal Medicine II, Fukushima Medical University |
Author |
Rei Suzuki |
Department of Internal Medicine II, Fukushima Medical University |
Author |
Katsutoshi Obara |
Department of Endoscopy Fukashima Medical University Hospital |
Author |
Hiromasa Ohira |
Department of Internal Medicine II, Fukushima Medical University |
[ Summary ] |
Endoscopic approaches, including transmural or transpapillary drainage, are first-line therapies for pancreatic pseudocysts (PPc) and other pancreatic collections. PPc can be divided into 3 types based on causative factors ; type 1, acute post-necrotic pseudocysts ; type 2, post-necrotic pseudocysts. associated with chronic pancreatitis ; and type 3, chronic pseudocysts (retention). In types 1 and 2, the omental sac that exists between the pancreas and the stomach itself forms a cystic cavity, resulting in a pseudocyst. The gastric wall thus becomes a cystic wall, and transmural drainage is indicated. Type 3 is basically an intrapancreatic cyst, and because the stomach is separate from the cyst, transpapillary drainage is indicated. In recent years, a technique to debride / lavage cysts by inserting an endoscope via the stomach has been reported with good results. The therapeutic strategy for PPc should be established based on causative factors associated with PPc. |