Endoscopic transmural drainage and necrosectomy of walled-off pancreatic necrosis / 中国内镜杂志

ABSTRACT

Pancreatic necrosis (IPN) is a serious complication of acute pancreatitis (AP), with a mortality reported to be as great as 32.0%. At present, it is considered that patients with proven or suspected infected necrotizing pancreatitis, invasive intervention (i.e. percutaneous catheter drainage, endoscopic transluminal drainage/ necrosectomy, minimally invasive or open necrosectomy) should be delayed where possible until at least 4 weeks after initial presentation to allow the collection to become 'walled-off'. With the development of endoscopic technology, endoscopic transmural (stomach or duodenum) drainage and necrosectomy has been recommended as one of the preferred methods for walled-off necrosis. This article introduces the diagnosis and evaluation of the walled-off necrosis ; the indications, operation procedures, postoperative evaluation and management of postoperative complications of endoscopic transmural drainage and necrosectomy. At last, the research progress of endoscopic drainage and debridement in recent years was introduced.