An overview of walled-off pancreatic necrosis for clinicians

Expert Review of Gastroenterology & Hepatology
Surinder Singh Rana

Abstract

Walled of pancreatic necrosis (WOPN) is a new term coined for encapsulated fluid collection developing after acute necrotising pancreatitis (ANP). It is a heterogeneous collection containing varying amount of liquid as well as solid necrotic material. The literature on its natural history as well as appropriate management is gradually expanding thereby improving treatment outcomes of this enigmatic disease. Areas covered: This review discusses currently available literature on etiology, frequency, natural history, and imaging features WOPN. Also, updated treatment options including endoscopic, radiological and surgical drainage are discussed. Expert opinion: WOPN is alocal complication of ANP occurring in the delayed phase of ANP and may be asymptomatic (50%) or present with pain, fever, jaundice, or gastric outlet obstruction. Natural courses of asymptomatic WOPN have been infrequently studied, and it appears that the majority remain asymptomatic and resolve spontaneously. Magnetic resonance imaging and endoscopic ultrasound are the best imaging modalities to evaluate solid necrotic debris. Symptomatic WOPN usually needs immediate drainage, this can be done endoscopically, radiologically, or surgically. Current evidence sugges...Continue Reading

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Citations

Jul 18, 2019·Current Opinion in Gastroenterology·Raj Dalsania, Field F Willingham
Apr 15, 2020·Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology·Jimil Shah, Surinder S Rana
Nov 25, 2020·Revista Española De Enfermedades Digestivas : Organo Oficial De La Sociedad Española De Patología Digestiva·Yongliang TangHongming Liu
Feb 7, 2021·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Surinder Singh RanaRajesh Gupta
Oct 27, 2020·Proceedings·Adwait MehtaNicole Thomason
Jan 7, 2021·Endoscopic Ultrasound·Surinder Singh RanaNavin Pandey
Mar 3, 2021·Digestive Diseases and Sciences·Surinder Singh RanaRajesh Gupta
Nov 30, 2020·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Surinder Singh Rana, Rajesh Gupta
Aug 14, 2021·JGH Open : an Open Access Journal of Gastroenterology and Hepatology·Junichi FujiwaraHirosato Mashima

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