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CC BY 4.0 · Journal of Digestive Endoscopy 2023; 14(04): 185-190
DOI: 10.1055/s-0043-1776715
Research Article

Impact of Direct Endoscopic Necrosectomy on Recurrence of Symptoms or Fluid Collections Following Successful Endoscopic Transmural Drainage of Walled-off Necrosis in Disconnected Pancreatic Duct

Surinder Singh Rana
1   Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Nikhil Bush
1   Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Ravi Sharma
1   Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Rajesh Gupta
2   Department of Surgical Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
› Author Affiliations Funding None.
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Abstract

Background The impact of direct endoscopic necrosectomy (DEN) on risk of recurrence of symptoms or pancreatic fluid collections (PFCs) in patients with disconnected pancreatic duct (DPD) has not been previously evaluated.

Objective To compare the risk of recurrence of PFC in patients with walled-off necrosis (WON) and DPD undergoing DEN with that of not requiring DEN and not having permanent indwelling plastic stents.

Methods Retrospective analysis of database of patients with WON successfully treated with transmural metal stents over the past 5 years was done to identify patients with DPD and not having permanent indwelling transmural stents. These patients were divided into two groups: Group A: patients undergoing DEN and Group B: patients not requiring DEN.

Results Seventeen patients required DEN (Group A; mean age 37.8 years) and 21 patients were successfully treated without DEN (Group B; mean age: 37.7 years). In Group A, none of the patients developed either recurrence of symptoms or PFC over a mean follow-up period of 7 months. In Group B, 5 of 21 (23.8%) patients developed either recurrence of pain (n = 2) or PFC (n = 3) over a mean follow-up period of 22 months. New-onset diabetes mellitus developed in five (29%) patients in Group A and two (9%) patients in Group B. None of the patients in either group developed steatorrhea.

Conclusion Patients with WON and DPD treated with lumen apposing metal stent and requiring DEN seem to be having low risk of developing recurrence of pain or PFC.

Keywords

endoscopic ultrasound - pancreatitis - lumen apposing metal stents - walled-off necrosis

Financial Disclosure

No financial disclosure to be made by any authors.


Authors' Contribution

S.S.R. collected and interpreted the data, drafted the manuscript, as well as performed the critical evaluation of manuscript for intellectual content. N.B. collected and interpreted the data, and drafted manuscript. R.S. and R.G. collected the data.




Publication History

Article published online:
20 November 2023

© 2023. 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/)

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