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

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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.

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  1. Department of Radiology, University of Kentucky Chandler Medical Center, 800 Rose St. HX315E, Lexington, KY, USA

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

  2. Department of Gastroenterology, University of Kentucky Chandler Medical Center, 800 Rose St, Lexington, KY, USA

    Frandah Wesam

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  1. Harit Kapoor
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Kapoor, H., Issa, M., Winkler, M.A. et al. The augmented role of pancreatic imaging in the era of endoscopic necrosectomy: an illustrative and pictorial review. Abdom Radiol 45, 1534–1549 (2020). https://doi.org/10.1007/s00261-019-02093-1

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