Endoscopic, transmural drainage and necrosectomy for walled-off pancreatic and peripancreatic necrosis is associated with low mortality – a single-center experience. (May 2014)

• Record Type: Journal Article
• Authors: Schmidt, Palle Nordblad; Novovic, Srdan; Roug, Stine; Feldager, Erik
• Is Part Of: Scandinavian journal of gastroenterology. Volume 50:Number 5(2015)
• Page Start: 611
• Page End: 618
• Publication Date: 2014-05
• Subjects: Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; 616.33
• DOI: 10.3109/00365521.2014.946078
• Languages: English
• ISSNs: 0036-5521

Abstract

<abstract> <title>Abstract</title> <p> <bold> <italic>Objective.</italic> </bold> Endoscopic transmural drainage and necrosectomy (ETDN) is a promising alternative to percutaneous drainage and surgical intervention in the treatment of walled-off pancreatic and peripancreatic necroses (WONs). We assessed the outcome and safety profile of ETDN in a single-center patient cohort. <bold><italic>Materials and methods.</italic></bold> In November 2005, ETDN for WON was introduced in our tertiary referral center. During a 6-year period (Nov 2005–Nov 2011), we retrospectively collected data on all patients who underwent ETDN. <bold><italic>Results.</italic></bold> Eighty-one patients were treated with ETDN (median age 54, 52 men). Gallstones were the predominant etiology of pancreatitis (41%), followed by alcohol (33%). Median time from debut of symptoms to first endoscopic treatment was 44 (9–246) days. Culture-proven infected necrosis was found in 71% of the cases. Twenty-three patients (28%) required admission in intensive care unit. The technical and clinical success rates were 99% and 89%, respectively. Procedure-related complications occurred in 10 (12%) patients, of which 1 was procedure-related death. In-hospital mortality was 11%. <bold><italic>Conclusion.</italic></bold> ETDN in patients with necrotizing pancreatitis and infected necrosis performed in a single, high-volume center has an acceptable safety profile and is associated with a low mortality.</p> </abstract>