Endoscopic necrosectomy of walled-off pancreatic necrosis using a lumen-apposing metal stent and irrigation technique

Surgical Endoscopy
Joan B GornalsJoan Fabregat

Abstract

Endoscopic management of walled-off pancreatic necrosis (WOPN) is an area of great interest with many still unanswered questions, including the role of mechanical necrosectomy versus irrigation. The aim of this study was to evaluate a new method of endoscopic transmural necrosectomy. Patients with WOPN after necrotizing pancreatitis, who underwent endoscopic transmural necrosectomy using a lumen-apposing metal stent with vigorous irrigation sessions, were prospectively recruited between September 2011 and August 2014. Initial endoscopic session was performed by EUS-guided drainage and lavage sessions by flushing saline through the stent. Technical and clinical success rates, number of repeat interventions, and adverse events were analyzed. Twelve patients with 13 WOPN collections (median size 12.4 ± 2.94 cm) underwent endoscopic treatment. Clinical success was achieved in 100 % of cases after a median of three sessions per patient (range 2-8). The median length of hospitalization was 15.9 days. Median procedure time of the access session was 31 ± 10.16 min. No adverse events (AE) were described during the procedures or 24 h after. There were four AE (two infections and two bleedings) between sessions, but only two were severe (...Continue Reading

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Citations

Aug 23, 2016·Expert Review of Medical Devices·Eduardo Rodrigues-Pinto, Todd H Baron
Sep 7, 2016·Annals of Medicine and Surgery·Suman B KogantiR A Sastry
Oct 11, 2017·Journal of Clinical Gastroenterology·Dennis HanDivyesh V Sejpal
Oct 24, 2017·Diagnostic and Therapeutic Endoscopy·Mohamed O OthmanBrian R Davis
Dec 20, 2018·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Takashi TamuraMasayuki Kitano
Nov 3, 2017·Journal of Clinical Gastroenterology·Iman AndalibMichel Kahaleh
Jan 17, 2020·Scandinavian Journal of Gastroenterology·Waseem AhmadWilson T Kwong
Oct 23, 2019·Journal of Translational Internal Medicine·Guoxin WangSiyu Sun
Feb 23, 2019·Expert Review of Gastroenterology & Hepatology·Surinder Singh Rana
Feb 23, 2020·Surgical Endoscopy·Jose Lariño-NoiaJ Enrique Domínguez-Muñoz
Aug 14, 2021·JGH Open : an Open Access Journal of Gastroenterology and Hepatology·Junichi FujiwaraHirosato Mashima
Feb 11, 2021·GE Portuguese Journal of Gastroenterology·Flávio PereiraMiguel Bispo

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