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Health Dictionary

Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Walled off pancreatic necrosis

Introduction

Walled off pancreatic necrosis is a complication of acute pancreatitis that usually occurs more than 4 weeks after acute pancreatitis.[1]

Treatment

Treatment

Options include[2]:

  • Lumen-apposing metal stents (LUMS)[3]
  • open surgical necrosectomy
  • minimally invasive surgical necrosectomy
  • percutaneous catheter drainage
  • endoscopic transgastric/transluminal drainage
  • direct endoscopic transgastric/transluminal necrosectomy
  • nasocystic drainage

A randomized controlled trial is underway to compare transluminal endoscopic step-up approach versus minimally invasive surgical step-up approach.[4]

References

References

  1. ↑ Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG; et al. (2013). “Classification of acute pancreatitis–2012: revision of the Atlanta classification and definitions by international consensus”. Gut. 62 (1): 102–11. doi:10.1136/gutjnl-2012-302779. PMID 23100216.
  2. ↑ Gurusamy KS, Belgaumkar AP, Haswell A, Pereira SP, Davidson BR (2016). “Interventions for necrotising pancreatitis”. Cochrane Database Syst Rev. 4: CD011383. doi:10.1002/14651858.CD011383.pub2. PMID 27083933.
  3. ↑ Sharaiha RZ, Tyberg A, Khashab MA, Kumta NA, Karia K, Nieto J; et al. (2016). “Endoscopic Therapy With Lumen-apposing Metal Stents Is Safe and Effective for Patients With Pancreatic Walled-off Necrosis”. Clin Gastroenterol Hepatol. doi:10.1016/j.cgh.2016.05.011. PMID 27189914.
  4. ↑ van Brunschot S, van Grinsven J, Voermans RP, Bakker OJ, Besselink MG, Boermeester MA; et al. (2013). “Transluminal endoscopic step-up approach versus minimally invasive surgical step-up approach in patients with infected necrotising pancreatitis (TENSION trial): design and rationale of a randomised controlled multicenter trial [ISRCTN09186711]”. BMC Gastroenterol. 13: 161. doi:10.1186/1471-230X-13-161. PMC 4222267. PMID 24274589.