Classification and endoscopic management of pancreatic fistulas

Figure 2 Proposed B-P-C-A classification framework for pancreatic fistula. Type B: Branch-duct leak with intact main pancreatic duct (MPD) continuity. Type P: Partial MPD disruption, with contrast beyond the disruption. Type C: Complete MPD disruption or disconnected pancreatic duct syndrome, with non-opacification beyond the interruption interpreted alongside computed tomography/magnetic resonance cholangiopancreatography to exclude obstruction and assess the upstream pancreas; C1 indicates a patent proximal duct and C2 indicates a stenotic or closed proximal duct. Type A: Postoperative stump or anastomotic leak, including distal pancreatectomy stump leak (A1) and pancreaticojejunostomy anastomotic leak (A2).