Abstract
Walled-off necrosis is a well-recognized complication of necrotizing pancreatitis. While small necrotic collections may resolve spontaneously, larger collections that cause sepsis, luminal obstruction, or persistent unwellness require multidisciplinary care for optimal clinical outcomes. In general, minimally invasive strategies are preferred over more invasive approaches. Close clinical follow-up, medical management, and nutritional support are critical for all patients. While endoscopic transmural drainage with or without necrosectomy is the primary approach for patients requiring an intervention, for collections not amenable to endoscopic approach, video-assisted retroperitoneal debridement, or laparoscopic cystogastrostomy with internal debridement are other alternatives. Image-guided percutaneous drain placement acts as a temporizing measure or as bridge to surgery in very sick patients. More studies are required to refine existing procedural techniques in order to make treatment modalities more effective and less cumbersome.
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Varadarajulu, S. (2020). Treatment of Walled-Off Necrosis. In: Testoni, P.A., Inoue, H., Wallace, M.B. (eds) Gastrointestinal and Pancreatico-Biliary Diseases: Advanced Diagnostic and Therapeutic Endoscopy. Springer, Cham. https://doi.org/10.1007/978-3-030-29964-4_96-1
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DOI: https://doi.org/10.1007/978-3-030-29964-4_96-1
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