Pancreatic Fluid Collections and Leaks

Abstract

Abstract Pancreatic fluid collections (PFCs) and leaks develop due to main or secondary pancreatic ductal disruption caused by acute or chronic pancreatitis, trauma, or pancreatic surgery. PFCs include acute fluid collections, acute necrotic collections, pseudocysts, and walled-off necrosis. Most nonnecrotic PFCs resolve spontaneously without need for drainage. Fluid collections that have become infected, or those that cause persistent symptoms, warrant drainage. Drainage of PFCs has historically been performed by open surgical approaches, but less invasive interventions have displaced open surgery over time. Whereas appropriate management of PFCs entails a multidisciplinary approach involving interventional endoscopy, interventional radiology, and minimally invasive surgery, endoscopic therapy of PFCs and pancreatic leaks has become a predominant initial therapeutic modality.