Copyright ©The Author(s) 2020.
World J Gastroenterol. Dec 7, 2020; 26(45): 7104-7117
Published online Dec 7, 2020. doi: 10.3748/wjg.v26.i45.7104
Table 1 Classifications of pancreatography findings
Ref.Study objectStudy objectiveDescriptorsClassificationPractical implication
Dhir et al[23], 2018EUS-drained WONPancreatography patters in WON and collection recurrence-Duct disconnection; -Leaks-Type I: Disconnection in the neck/body region, with a ductal leak at the proximal end; -Type II: Disconnected duct with a WON distal to the disconnection. It is not possible to ascertain the ductal communication of WON; -Type III: ductal leak without disconnection; -Type IV: Shows a noncommunicating WON, with no disconnectionRecurrence is higher in patters w/ disconnection (types I and II): -Type I: 5/35 patients (14.3%)–62.5% of recurrences; -Type II: 2/18 patients (11.1%) - 25% of recurrences; -Type III: 0/26 patients (0%) - 0% of recurrences; -Type IV: 1/8 patients (12.5%)–12.5% of recurrences
Mutignani et al[35], 2017All pancreatic fistulasGuide endoscopic approach-Leakages; -Disruption (partial); -Disconnection (total)-Type I: Leakages from small side brunches. IH: head | IB: body | IT: tail; -Type II: Leak in the MPD Open (IIO) or Close (IIC); -Type III: leaks after pancreatectomy; IIIP: Proximal pancreas (after distal pancreatectomy); IIID: Distal pancreas (after pancreaticoduodenectomy)-IH and IB: Bridging OR NPD; -IT: Bridging OR cianoacrilate/fibrin/glue/polymer injection at pancreatic tail; -IIO: Bridging OR NPD OR transpapillary stent; -IIC: EUS transmural drain of collection from excluded gland OR EUS pancreaticogastrostomy OR Conversion to IIO and treat as IIO; -IIIP: Transpapillary stent; -IIID: Few endoscopic options. EUS transmural drainage OR nasojejunal drain at the level of dehiscence in continuous aspiration
Nealon et al[37], 2009Pseudocyst due to pancreatitis1Guide the best approach: endoscopic, interventional radiology or surgical intervention-Normal2; -Stricture; -Chronic pancreatitis; -Occlusion; -Communication / no communication with collection-Type I for normal ducts, IA: No communication, IB: With communication; -type II for duct strictures; IIA: no communication; IIB: with communication; -Type III for duct occlusion or disconnected duct syndrome; IIIA: no communication; IIIB: with communication; - Type IV for changes of chronic pancreatitis; IVA: no communication, IVB: with communication-Type I: Endoscopic or percutaneous management; unlikely to require operation; -Type II: Endoscopic management depending on the magnitude and length of the stricture - transpapillary stents for selected ducts; -Type III and type IV: Surgical intervention exclusively
Nealon et al[41], 2002Pseudocyst1 that underwent pancreatography by ERCPGuide the best approach between percutaneous drainage or surgical intervention-Normal2; -Strictures; -Complete cutoff; -Chronic pancreatitis;-MPD-pseudocyst communication or not-Type I: normal duct/no communication with cyst; -Type II: normal duct with duct–cyst communication; -Type III: otherwise normal duct with stricture and no duct–cyst communication; -Type IV: otherwise normal duct with stricture and duct–cyst communication; -Type V: otherwise normal duct with complete cut-off; -Type VI: chronic pancreatitis, no duct–cyst communication; -Type VII: chronic pancreatitis with duct–cyst communication-Type I: consider percutaneous drainage (PD); -Type II: avoid PD; -Type III: consider PD treatment; -Type IV: surgery (avoid PD); -Type V: surgery (avoid PD); -Type VI: surgery (avoid PD); -Type VII: surgery (avoid PD)
Nordback et al[7], 1988Pseudocyst1 that underwent pancreatography by ERCPGuide the best approach-Stenosis; -Pseudocyst opens to the duct; -Pseudocyst is filled-Type I: MPD is imaged up to the end without much stenosis, Pseudocyst may (Type IA) or may not (IB) be filled, but is further away from the main pancreatic duct; -Type II: no main duct stenosis and pseudocyst opens to the duct; -Type III: stenosis of the main pancreatic duct, + filling of the pseudocyst behind the stenosis (IIIA), or not (IIIB)Type I: PD is a good option; Type II: expectant management for 12 wk, if persistent: Internal drainage (PD, endoscopically, surgery); Type III: Internal drainage (external drainage contraindicated); caudal resection