TY - JOUR
T1 - Endoscopic necrosectomy is safe in patients with pancreatic walled-off necrosis
T2 - Insights from a tertiary center study of 880 procedures
AU - Jensen, Julie Falkebo
AU - Stinne Timmner, Joy
AU - Hadi, Amer
AU - Feldager, Erik
AU - Prahm, August Pilegaard
AU - Ebrahim, Mohamed
AU - Olsen, Gitte Aabye
AU - Roug, Stine
AU - Novovic, Srdan
AU - Karstensen, John Gásdal
N1 - The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).
PY - 2025
Y1 - 2025
N2 - BACKGROUND AND STUDY AIMS: Endoscopic transmural drainage with subsequent endoscopic necrosectomy (EN) has become the first-line treatment for acute necrotizing pancreatitis with walled-off necrosis (WON). There is a growing interest in incorporating EN at the index intervention; however, data about the safety of EN are limited. This case series evaluated the rate and type of adverse events (AEs) associated with EN.PATIENTS AND METHODS: We retrospectively included consecutive patients with WON from 2012 to 2024 who underwent EN in our tertiary referral center. An AE was defined as any event leading to premature cessation of necrosectomy or requiring intervention either during the procedure or within 24 hours of the procedure.RESULTS: A total of 235 patients and 880 EN procedures (median: 3, interquartile range: 2-5) were recorded. The median age of patients was 57.5 years, of whom 116 were female (49.3%). Snares were used in most procedures (90.9%), EndoRotor in 4.3%, and both were used in 4.8% of procedures. A total of 14 AEs (1.6%) were identified in 11 different patients (4.7%): 13 bleeds and one pneumoperitoneum. In-hospital mortality was significantly higher in the AE group (45.5%) than in the non-AE group (10.3%, P = 0.0004).CONCLUSIONS: AEs are rare in EN but are associated with increased mortality.
AB - BACKGROUND AND STUDY AIMS: Endoscopic transmural drainage with subsequent endoscopic necrosectomy (EN) has become the first-line treatment for acute necrotizing pancreatitis with walled-off necrosis (WON). There is a growing interest in incorporating EN at the index intervention; however, data about the safety of EN are limited. This case series evaluated the rate and type of adverse events (AEs) associated with EN.PATIENTS AND METHODS: We retrospectively included consecutive patients with WON from 2012 to 2024 who underwent EN in our tertiary referral center. An AE was defined as any event leading to premature cessation of necrosectomy or requiring intervention either during the procedure or within 24 hours of the procedure.RESULTS: A total of 235 patients and 880 EN procedures (median: 3, interquartile range: 2-5) were recorded. The median age of patients was 57.5 years, of whom 116 were female (49.3%). Snares were used in most procedures (90.9%), EndoRotor in 4.3%, and both were used in 4.8% of procedures. A total of 14 AEs (1.6%) were identified in 11 different patients (4.7%): 13 bleeds and one pneumoperitoneum. In-hospital mortality was significantly higher in the AE group (45.5%) than in the non-AE group (10.3%, P = 0.0004).CONCLUSIONS: AEs are rare in EN but are associated with increased mortality.
U2 - 10.1055/a-2737-6307
DO - 10.1055/a-2737-6307
M3 - Journal article
C2 - 41567603
SN - 2364-3722
VL - 13
JO - Endoscopy International Open
JF - Endoscopy International Open
M1 - a27376307
ER -