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World J Gastrointest Endosc. Nov 16, 2026; 18(11): 126239
Published online Nov 16, 2026. doi: 10.4253/wjge.126239
Published online Nov 16, 2026. doi: 10.4253/wjge.126239
Classification and endoscopic management of pancreatic fistulas
Zi-Yi He, School of Medicine, Nankai University, Tianjin 300071, China
De-Xin Chen, Ya-Qi Zhai, Ming-Yang Li, Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
Co-first authors: Zi-Yi He and De-Xin Chen.
Co-corresponding authors: Ya-Qi Zhai and Ming-Yang Li.
Author contributions: He ZY and Chen DX contributed equally to this work, as they are co-first authors; He ZY and Chen DX performed the literature search and drafted the manuscript; Li MY and Zhai YQ conceived the review, critically revised the manuscript, and supervised the work; Li MY and Zhai YQ contributed equally to correspondence, supervision, and responsibility for the work, as they are co-corresponding authors.
AI contribution statement: Portions of this manuscript were edited using ChatGPT (OpenAI) solely for language refinement. The authors carefully reviewed and verified all AI-assisted outputs and take full responsibility for the scientific content of the manuscript.
Supported by the Military High-level Scientific and Technological Innovation Talent Project 2024, No. GCCRC-2024-011.
Conflict-of-interest statement: All authors declare that the manuscript was prepared in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Corresponding author: Ming-Yang Li, MD, Doctor, Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China. mingyangli_pla@163.com
Received: July 29, 2026
Revised: October 7, 2026
Accepted: October 28, 2026
Published online: November 16, 2026
Processing time: 107 Days and 17.2 Hours
Revised: October 7, 2026
Accepted: October 28, 2026
Published online: November 16, 2026
Processing time: 107 Days and 17.2 Hours
Core Tip
Core Tip: Pancreatic fistula should be managed according to pancreatic duct anatomy and endoscopic feasibility. Endoscopic retrograde cholangiopancreatography with transpapillary pancreatic duct stenting is useful when ductal continuity is preserved and the ductal disruption can be bridged. When ductal continuity is lost or complex collections and surgically altered anatomy are present, endoscopic ultrasound-guided approaches may provide internal drainage. This minireview proposes an endoscopy-oriented classification framework to guide treatment selection.