Clinical Practice Guidelines for the Endoscopic Management of Peripancreatic Fluid Collections

Abstract

Endoscopic ultrasonography-guided intervention has gradually become a standard treatment for peripancreatic fluid collections (PFCs). However, it is difficult to popularize the procedure in Korea because of restrictions on insurance claims regarding the use of endoscopic accessories, as well as the lack of standardized Korean clinical practice guidelines. The Korean Society of Gastrointestinal Endoscopy (appointed a Task Force to develope medical guidelines by referring to the manual for clinical practice guidelines development prepared by the National Evidence-Based Healthcare Collaborating Agency. Previous studies on PFCs were searched, and certain studies were selected with the help of experts. Then, a set of key questions was selected, and treatment guidelines were systematically reviewed. Answers to these questions and recommendations were selected via peer review. This guideline discusses endoscopic management of PFCs and makes recommendations on indication for the procedure, pre-procedural preparations, optimal approach for drainage, procedural considerations (e.g., types of stent, advantages and disadvantages of plastic and metal stents, and accessories), adverse events of endoscopic intervention, and procedural quality issues. This guideline was reviewed by external experts and suggests best practices recommended based on the evidence available at the time of preparation. This will be revised as necessary to address advances and changes in technology and evidence obtained in clinical practice and future studies.

가성낭종과 같은 췌장주변저류액의 내시경 치료는 표준치료로 인정받고 있으며, 최근에 초음파 내시경 중재술을 이용한 치료의 효과 및 안전성은 충분히 증명되었다. 이에 우리나라 상황에 맞는 임상진료지침이 필요하다. 이 진료지침은 국내에서 처음으로 만들어진 췌장주변저류액의 내시경 치료에 관한 임상진료지침으로 환자를 진단하고 적절한 치료를 제공하는 데 사용될 것으로 기대된다.