학술논문

Direct Endoscopic Necrosectomy: Timing and Technique
Document Type
article
Source
Medicina, Vol 57, Iss 12, p 1305 (2021)
Subject
walled-off pancreatic necrosis
pancreatic necrotic collection
acute pancreatitis
direct endoscopic necrosectomy
EUS
LAMS
Medicine (General)
R5-920
Language
English
ISSN
1648-9144
1010-660X
Abstract
Walled-off pancreatic necrosis (WOPN) is one of the local complications of acute pancreatitis (AP). Several interventional techniques have been developed over the last few years. The purpose of this narrative review is to explore such methodologies, with specific focus on endoscopic drainage and direct endoscopic necrosectomy (DEN), through evaluation of their indications and timing for intervention. Findings indicated how, after the introduction of lumen-apposing metal stents (LAMS), DEN is becoming the favorite technique to treat WOPN, especially when large solid debris or infection are present. Additionally, DEN is associated with a lower adverse events rate and hospital stay, and with improved clinical outcome.