Selection strategy for endoscopic necrosectomy approaches of infected walled‐off pancreatic necrosis: Analysis of 101 patients from a single center with long‐term follow‐up

Author:

Luo Jie1,Zhang Sheng Wei1,He Jia Lin1,Tian Li Xing1,Peng Xue1,Nie Xu Biao1,Ye Shao Song1,Zuo Ying1,Lin Hui2,Bai Jian Ying1,Liu En1,Yang Shi Ming1,Fan Chao Qiang1ORCID

Affiliation:

1. Department of Gastroenterology, Xinqiao Hospital Army Medical University Chongqing China

2. Department of Epidemiology Army Medical University Chongqing China

Abstract

ObjectivesEndoscopic necrosectomy (EN) is a promising minimally invasive approach for treating infected walled‐off pancreatic necrosis (WOPN). Multiple EN approaches are currently available, though criteria for selecting the optimal approaches are lacking. We aimed to propose a rational selection strategy of EN and to retrospectively evaluate its safety and effectiveness.MethodsAltogether 101 patients who underwent EN for infected WOPN at a tertiary hospital between June 2009 and February 2023 were retrospectively included for analysis. Demographic characteristics, details of the EN procedures, procedure‐related adverse events, and clinical outcomes were investigated.ResultsAmong these 101 patients with WOPN, 56 (55.4%) underwent transluminal EN, 38 (37.6%) underwent percutaneous EN, and seven (6.9%) underwent combined approach, respectively. Clinical success was achieved in 94 (93.1%) patients. Seven (6.9%) experienced procedure‐related adverse events, and seven (6.9%) died during the treatment period. During a median follow‐up of 50 months, 5 (5.3%) of the 94 patients had disease recurrence, 17.0% (16/94) had new‐onset diabetes mellitus, and 6.4% (6/94) needed oral pancreatic enzyme supplementation. The clinical success rate, procedure‐related adverse event rate, and long‐term follow‐up outcomes were not significantly different among the three groups. High APACHE‐II scores (≥15) and organ failure were identified as factors related to treatment failure.ConclusionsA selection strategy for EN approaches, based on the extent of necrosis and its distance from the gastrointestinal lumen (using a threshold of 15 mm), is safe and effective for treating infected WOPN in both short‐term and long‐term outcomes.

Funder

National Natural Science Foundation of China

Publisher

Wiley

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3