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Early Endoscopic Interventions for Pancreatic Necrosis: Indications, Technique, and Outcomes

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Abstract

Endoscopic transmural drainage is usually performed for symptomatic well-encapsulated walled-off necrosis (WON) that usually develops in the delayed phase (> 4 weeks after disease onset) of acute necrotising pancreatitis (ANP). Endoscopic drainage is usually not advocated in the early (< 4 weeks after disease onset) stage of illness because of the risk of complications due to an incompletely formed encapsulating wall and poor demarcation of viable from necrotic tissue. However, emerging data from expert tertiary care centres over the last few years shows that the early endoscopic transluminal drainage approach is effective and safe. The development of lumen-apposing metal stents and better accessories for endoscopic necrosectomy has fuelled the expansion of indications of endoscopic drainage of pancreatic necrosis. However, early endoscopic drainage is associated with higher rates of adverse events; therefore, careful patient selection is paramount. This article will review the current indications, techniques and outcomes of early endoscopic transluminal drainage in pancreatic necrotic collections.

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Authors and Affiliations

  1. Department of Gastroenterology, Post Graduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh, 160012, India

    Pardhu Neelam Bharath & Surinder Singh Rana

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  1. Pardhu Neelam Bharath
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PNB: collection of data, Writing of the manuscript. SSR: writing as well as critical evaluation of the manuscript.

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Correspondence to Surinder Singh Rana.

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Bharath, P.N., Rana, S.S. Early Endoscopic Interventions for Pancreatic Necrosis: Indications, Technique, and Outcomes. Dig Dis Sci 69, 1571–1582 (2024). https://doi.org/10.1007/s10620-024-08347-3

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