Classification and endoscopic management of pancreatic fistulas

Figure 1 Previous classification systems relevant to pancreatic fistula and endoscopic decision-making. A: Nordback et al[12] classification: Type I, normal main pancreatic duct (MPD) with (IA) or without (IB) collection filling; Type II, MPD opens to the collection; Type III, MPD stricture with (IIIA) or without (IIIB) collection filling; B: Nealon et al[31] classification: Type I, normal MPD; Type II, MPD stricture; Type III, MPD occlusion; Type IV, chronic pancreatitis; Subtype A indicates no communication between the pancreatic duct and the collection, and subtype B indicates communication; C: Mutignani et al[3] classification: Type I, side-branch leak in the pancreatic head, body, or tail; Type II, MPD leak with open or closed proximal stump; Type III, post-pancreatectomy leak after proximal or distal pancreatic resection; D: Proença et al[11] classification: Type I, normal MPD; Type II, MPD stricture; Type III, partial disruption; Type IV, complete disruption with (IV-A) or without (IV-B) contrast extravasation.