ArticleWorld journal of gastrointestinal endoscopy2025
Predictive factors and outcomes of endoscopic necrosectomy in patients with acute pancreatitis and walled-off necrosis.
Article in World journal of gastrointestinal endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundEndoscopic ultrasound-guided drainage using lumen-apposing metal stents (LAMS) has emerged as the first-line approach for managing walled-off necrosis (WON). However, certain patients require escalation to direct endoscopic necrosectomy, for which the predictive factors have not been completely defined.
aimTo determine the predictors of direct endoscopic necrosectomy following LAMS placement in patients with WON and to assess the clinical outcomes and safety.
methodsA retrospective analysis of prospectively collected data from patients with acute pancreatitis who were admitted to the Govind Ballabh Pant Institute of Postgraduate Medical Education in Delhi, India, between January 2020 and October 2023 was conducted. Patients with acute pancreatitis and symptomatic WON who underwent LAMS placement were included in the study. Patients aged < 18 years with asymptomatic WON, pseudocysts, postsurgical collections, or a history of percutaneous drainage were excluded. Data were collected using a predesigned form. Clinical details, treatments, interventions, and outcome data were recorded.
resultsA total of 104 patients with symptomatic pancreatic WON who underwent LAMS placement were included in this study. Of these, 36 required endoscopic necrosectomy. Univariate analysis revealed that fever [odds ratio (OR) = 4.47, 95% confidence interval (CI): 1.85-10.79,
conclusionEarly identification of these predictive variables can guide treatment planning for WON and facilitate early necrosectomy, thereby improving the clinical outcomes.
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