{"title":"Timing It Right: Endoscopic Necrosectomy for Infected Necrotizing Pancreatitis","authors":"Ashutosh Ishan Yadav, S. S. Rana","doi":"10.1055/s-0044-1782232","DOIUrl":null,"url":null,"abstract":"The endoscopic step-up drainage approach involving initial drainage followed by, if required, direct endoscopic necrosectomy (DEN) is the preferred management approach for symptomatic pancreatic necrotic collections. However, limited data suggests that immediate DEN during initial stent placement may hasten clinical recovery by quicker resolution of systemic inflammatory response. However, because of concerns about adverse effects, especially gastric perforation and bleeding, most endoscopists prefer delayed DEN. In this news and views, we discuss a recently published randomized controlled trial that compared upfront necrosectomy at the index intervention versus as a step-up for patients with infected necrotizing pancreatitis.","PeriodicalId":43098,"journal":{"name":"Journal of Digestive Endoscopy","volume":null,"pages":null},"PeriodicalIF":0.4000,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Digestive Endoscopy","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1055/s-0044-1782232","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
The endoscopic step-up drainage approach involving initial drainage followed by, if required, direct endoscopic necrosectomy (DEN) is the preferred management approach for symptomatic pancreatic necrotic collections. However, limited data suggests that immediate DEN during initial stent placement may hasten clinical recovery by quicker resolution of systemic inflammatory response. However, because of concerns about adverse effects, especially gastric perforation and bleeding, most endoscopists prefer delayed DEN. In this news and views, we discuss a recently published randomized controlled trial that compared upfront necrosectomy at the index intervention versus as a step-up for patients with infected necrotizing pancreatitis.
期刊介绍:
The Journal of Digestive Endoscopy (JDE) is the official publication of the Society of Gastrointestinal Endoscopy of India that has over 1500 members. The society comprises of several key clinicians in this field from different parts of the country and has key international speakers in its advisory board. JDE is a double-blinded peer-reviewed, print and online journal publishing quarterly. It focuses on original investigations, reviews, case reports and clinical images as well as key investigations including but not limited to cholangiopancreatography, fluoroscopy, capsule endoscopy etc.