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Endoscopic management of pancreatic walled-off necrosis.

par Ramai, Daryl;Morgan, Adrienne;Gkolfakis, Paraskevas;Facciorusso, Antonio;Chandan, Saurabh;Papaefthymiou, Apostolis;Morris, J;Arvanitakis, Marianna ;Adler, Dan
Référence Annals of Gastroenterology, 36, 2, page (123-131)
Publication Publié, 2023-10-01

Article révisé par les pairs

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Résumé :

Pancreatic walled-off necrosis (WON) is a complication of severe pancreatitis. Endoscopic transmural drainage has been recognized as the first-line treatment for pancreatic fluid collections. Endoscopy offers a minimally invasive approach when compared to surgical drainage. Today, endoscopists may choose to use self-expanding metal stents, pigtail stents, or lumen-apposing metal stents to facilitate drainage of fluid collections. Current data suggest that all 3 approaches yield similar outcomes. It was previously thought that drainage should be performed 4 weeks from the initial event of pancreatitis, theoretically allowing the capsule to mature. However, current data show that both early (<4 weeks) and standard (≥4 weeks) endoscopic drainage are comparable. Herein, we provide an up-to-date state-of-the-art review of the indications, techniques, innovations, outcomes, and future perspectives following drainage of pancreatic WON.