Manejo endoscópico de complicaciones tardías de la pancreatitis aguda. Revisión Bibliográfica

Abstract

Acute pancreatitis is one of the most common gastrointestinal pathologies, and its management is challenging in the presence of late complications such as walled-off necrosis and pancreatic pseudocyst, which are associated with a mortality rate of approximately 20-40%. Previously, the frontline management for complications of acute pancreatitis was debridement through open surgery. However, it has been determined that this is related to a higher risk of morbidity and mortality, leading to the development of minimally invasive procedures for its resolution. Objective: To determine the endoscopic management of late complications of acute pancreatitis. Methodology: It was a narrative work as a literature review; a search was conducted on scientific documents published from 2019 to 2023 on biomedical databases. Results: Pancreatic pseudocysts and walled-off necrosis are complications that occur four weeks after the disease's onset. They are often resolved spontaneously, but in some cases, drainage is required. Endoscopic techniques such as transmural and transpapillary drainage can be employed. The technique and instruments depend on the characteristics of the lesion and each patient. Conclusions: Late complications were previously managed surgically, but over time, it has been shown that endoscopic management has advantages in terms of costs and hospital stay; also, it presents lower morbidity and mortality and a higher success rate with fewer postoperative difficulties.