{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T18:22:39Z","timestamp":1778869359448,"version":"3.51.4"},"reference-count":24,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background Endoscopic intervention for pancreatic fluid collections (PFCs) with disconnected pancreatic duct syndrome (DPDS) has been associated with failures and increased need for additional endoscopic and non-endoscopic interventions. The primary aim of this study was to determine the outcomes of endoscopic ultrasound (EUS)-guided transmural drainage of PFCs in patients with DPDS.<\/jats:p><jats:p>\n          Methods In patients undergoing EUS-guided drainage of PFCs from January 2013 to January 2018, demographic profiles, procedural indications and details, adverse events, outcomes, and subsequent interventions were retrospectively collected. Overall treatment success was determined by PFC resolution on follow-up imaging or stent removal without recurrence.<\/jats:p><jats:p>\n          Results EUS-guided drainage of PFCs was performed in 141 patients. DPDS was present in 57 of them (40\u200a%) and walled-off necrosis was the most frequent type of PFC (55\u200a%). DPDS was not associated with lower clinical success, increased number of repeat interventions, or increased time to PFC resolution. Patients with DPDS were more likely to be treated with permanent transmural plastic double-pigtail stents (odds ratio [OR] 6.4; 95\u200a% confidence interval [CI] 2.5\u200a\u2013\u200a16.5; P\u200a&lt;\u200a0.001). However, when stents were removed, DPDS was associated with increased PFC recurrence after stent removal (OR 8.0; 95\u200a%CI 1.2\u200a\u2013\u200a381.8; P\u200a=\u200a0.04).<\/jats:p><jats:p>\n          Conclusions DPDS frequently occurs in patients with PFCs but does not negatively impact successful resolution. DPDS is associated with increased PFC recurrence after stent removal.<\/jats:p>","DOI":"10.1055\/a-1213-1489","type":"journal-article","created":{"date-parts":[[2020,7,6]],"date-time":"2020-07-06T23:20:32Z","timestamp":1594077632000},"page":"603-610","source":"Crossref","is-referenced-by-count":23,"title":["Impact of disconnected pancreatic duct syndrome on endoscopic ultrasound-guided drainage of pancreatic fluid collections"],"prefix":"10.1055","volume":"53","author":[{"given":"Lillian","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic at Rochester, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sherif","family":"Elhanafi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Texas Tech University Health Sciences Center, El Paso, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew C.","family":"Storm","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic at Rochester, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark D.","family":"Topazian","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic at Rochester, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shounak","family":"Majumder","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic at Rochester, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barham K.","family":"Abu Dayyeh","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic at Rochester, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J.","family":"Levy","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic at Rochester, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bret T.","family":"Petersen","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic at Rochester, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John A.","family":"Martin","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic at Rochester, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suresh T.","family":"Chari","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic at Rochester, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Santhi S.","family":"Vege","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic at Rochester, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vinay","family":"Chandrasekhara","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic at Rochester, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2020,8,4]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1136\/gutjnl-2012-302779","article-title":"Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus","volume":"62","author":"P A Banks","year":"2013","journal-title":"Gut"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1097\/MPA.0000000000000216","article-title":"Disconnected pancreatic duct syndrome: endoscopic stent or surgeon's knife?","volume":"44","author":"N A Nadkarni","year":"2015","journal-title":"Pancreas"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1016\/j.gie.2007.07.017","article-title":"Disconnected pancreatic tail syndrome: potential for endoscopic therapy and results of long-term follow-up","volume":"67","author":"C Lawrence","year":"2008","journal-title":"Gastrointest Endosc"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1016\/j.jamcollsurg.2008.12.027","article-title":"A unifying concept: pancreatic ductal anatomy both predicts and determines the major complications resulting from pancreatitis","volume":"208","author":"W H Nealon","year":"2009","journal-title":"J Am Coll Surg"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1016\/j.gie.2008.02.057","article-title":"EUS versus surgical cyst-gastrostomy for management of pancreatic pseudocysts","volume":"68","author":"S Varadarajulu","year":"2008","journal-title":"Gastrointest Endosc"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1136\/flgastro-2014-100444","article-title":"Endoscopic management of peripancreatic fluid collections","volume":"6","author":"J Goyal","year":"2015","journal-title":"Frontline Gastroenterol"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.1016\/j.gie.2008.04.028","article-title":"Prospective randomized trial comparing EUS and EGD for transmural drainage of pancreatic pseudocysts (with videos)","volume":"68","author":"S Varadarajulu","year":"2008","journal-title":"Gastrointest Endosc"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1016\/S0016-5107(04)02832-9","article-title":"Predictors of outcome in pancreatic duct disruption managed by endoscopic transpapillary stent placement","volume":"61","author":"S Varadarajulu","year":"2005","journal-title":"Gastrointest Endosc"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1097\/MCG.0000000000000754","article-title":"Permanent indwelling transmural stents for endoscopic treatment of patients with disconnected pancreatic duct syndrome: long-term results","volume":"52","author":"F I Tellez-Avina","year":"2018","journal-title":"J Clin Gastroenterol"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1016\/j.gie.2015.10.040","article-title":"Transpapillary drainage has no added benefit on treatment outcomes in patients undergoing EUS-guided transmural drainage of pancreatic pseudocysts: a large multicenter study","volume":"83","author":"D Yang","year":"2016","journal-title":"Gastrointest Endosc"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1097\/SLA.0000000000002082","article-title":"Impact of disconnected pancreatic duct syndrome on the endoscopic management of pancreatic fluid collections","volume":"267","author":"J Y Bang","year":"2018","journal-title":"Ann Surg"},{"key":"ref12","first-page":"535","article-title":"Current uses and outcomes of lumen-apposing metal stents","volume":"31","author":"A Mussetto","year":"2018","journal-title":"Ann Gastroenterol"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1097\/MCG.0000000000000934","article-title":"Lumen apposing metal stents (LAMSs) for drainage of pancreatic and gallbladder collections: a meta-analysis","volume":"52","author":"D Han","year":"2018","journal-title":"J Clin Gastroenterol"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1016\/j.cgh.2014.09.047","article-title":"Safety and efficacy of endoscopic ultrasound-guided drainage of pancreatic fluid collections with lumen-apposing covered self-expanding metal stents","volume":"13","author":"R J Shah","year":"2015","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"337","DOI":"10.5946\/ce.2012.45.3.337","article-title":"Endoscopic ultrasound-guided drainage of pancreatic fluid collections (with video)","volume":"45","author":"M Topazian","year":"2012","journal-title":"Clin Endosc"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"1408","DOI":"10.1016\/j.gie.2011.07.049","article-title":"Endoscopic placement of permanent indwelling transmural stents in disconnected pancreatic duct syndrome: does benefit outweigh the risks?","volume":"74","author":"S Varadarajulu","year":"2011","journal-title":"Gastrointest Endosc"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1016\/S0016-5107(95)70048-X","article-title":"Complete disruption of the main pancreatic duct: endoscopic management","volume":"42","author":"J Deviere","year":"1995","journal-title":"Gastrointest Endosc"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1016\/j.gie.2006.06.083","article-title":"Pancreatic-fluid collections: a randomized controlled trial regarding stent removal after endoscopic transmural drainage","volume":"65","author":"M Arvanitakis","year":"2007","journal-title":"Gastrointest Endosc"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"208","DOI":"10.4103\/2303-9027.162999","article-title":"Factors determining recurrence of fluid collections following migration of intended long term transmural stents in patients with walled off pancreatic necrosis and disconnected pancreatic duct syndrome","volume":"4","author":"S S Rana","year":"2015","journal-title":"Endosc Ultrasound"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.gie.2017.04.032","article-title":"Large-caliber metal stents versus plastic stents for the management of pancreatic walled-off necrosis","volume":"87","author":"B K Abu Dayyeh","year":"2018","journal-title":"Gastrointest Endosc"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1055\/s-0029-1215133","article-title":"Endoscopic ultrasound-guided versus conventional transmural drainage for pancreatic pseudocysts: a prospective randomized trial","volume":"41","author":"D H Park","year":"2009","journal-title":"Endoscopy"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"E883","DOI":"10.1055\/s-0042-112586","article-title":"EUS correlates of disconnected pancreatic duct syndrome in walled-off necrosis","volume":"4","author":"J Y Bang","year":"2016","journal-title":"Endosc Int Open"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"1608","DOI":"10.1007\/s00261-014-0303-x","article-title":"CT and MRI assessment of symptomatic organized pancreatic fluid collections and pancreatic duct disruption: an interreader variability study using the revised Atlanta classification 2012","volume":"40","author":"A Kamal","year":"2015","journal-title":"Abdom Imaging"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1097\/MCG.0b013e31825003b3","article-title":"Accuracy of magnetic resonance cholangiopancreatography in identifying pancreatic duct disruption","volume":"46","author":"L M Drake","year":"2012","journal-title":"J Clin Gastroenterol"}],"container-title":["Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1213-1489.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,10]],"date-time":"2022-08-10T09:44:36Z","timestamp":1660124676000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1213-1489"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,6]]},"references-count":24,"journal-issue":{"issue":"06","published-online":{"date-parts":[[2021,5,26]]},"published-print":{"date-parts":[[2021,6]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1213-1489","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0013-726X","1438-8812"],"issn-type":[{"value":"0013-726X","type":"print"},{"value":"1438-8812","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,7,6]]},"published":{"date-parts":[[2020,7,6]]}}}