Endoscopic “Step‑up” Treatment Approach for Walled off Pancreatic Necrosis

Endoscopic Necrosectomy for Walled-Off Pancreatic Necrosis

Approximately 20% of patients with acute pancreatitis develop pancreatic necrosis with significant mortality. Surgical debridement is the traditional management of necrotizing pancreatitis, but it is associated with significant morbidity and mortality. Endoscopic necrosectomy using repeats session of debridement and stent insertion has been more frequently used within the last decade and half. ...

Walled-off pancreatic necrosis.

Acute severe pancreatitits may be complicated by the development of 'walled-off pancreatic necrosis' (WOPN), which is characterised by a mixture of solid components and fluids on imaging studies as a consequence of organised pancreatic tissue necrosis. We present here an overview of the definition, clinical features, and diagnostic and therapeutic management of this clinical condition, which is...

Technical Advancement in Endoscopic Treatment of Walled-off Necrosis

Pancreatic fluid collection (PFC) is a frequent complication of pancreatitis. It is estimated that 5-15% of pancreatitis episodes are complicated by development of pseudocysts[1]. Fifteen percent of pancreatitis episodes are complicated by pancreatic necrosis, and approximately 33% (range 16-47%) of those with necrosis are complicated by infected necrosis[2]. Management of these collections can...

Endoscopic treatment of multilocular walled-off pancreatic necrosis with the multiple transluminal gateway technique

The development of minimally invasive techniques allowed access to the necrotic cavity through transperitoneal, retroperitoneal, transmural and transpapillary routes. The choice of access to walled-off pancreatic necrosis (WOPN) should depend not only on the spread of necrosis, but also on the experience of the clinical center. Herein we describe treatment of a patient with multilocular symptom...

Treatment of walled-off pancreatic necrosis: when and how?