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Endoscopic Procedures V: ERCP

Endoscopic Procedures V: ERCP

Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
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Related Experiment Video

Updated: Oct 9, 2025

Indocyanine Green-Guided Intraoperative Imaging to Facilitate Video-Assisted Retroperitoneal Debridement for Treating Acute Necrotizing Pancreatitis

Indocyanine Green-Guided Intraoperative Imaging to Facilitate Video-Assisted Retroperitoneal Debridement for Treating Acute Necrotizing Pancreatitis

Published on: September 8, 2022

Direct Endoscopic Necrosectomy: Timing and Technique.

Sergio Pinto¹, Saverio Bellizzi², Roberta Badas¹

¹Digestive Endoscopy Unit, Department of Surgical Sciences, University Hospital of Cagliari, 09042 Cagliari, Italy.

Medicina (Kaunas, Lithuania)

|December 24, 2021

Summary

This summary is machine-generated.

Direct endoscopic necrosectomy (DEN) is now a preferred method for treating walled-off pancreatic necrosis (WOPN), particularly when using lumen-apposing metal stents (LAMS). This approach offers improved outcomes and fewer complications compared to other interventions.

Keywords:

EUS LAMS acute pancreatitis direct endoscopic necrosectomy pancreatic necrotic collection walled-off pancreatic necrosis

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Area of Science:

Gastroenterology and Hepatology
Surgical Gastroenterology

Background:

Walled-off pancreatic necrosis (WOPN) is a significant local complication of acute pancreatitis (AP).
Minimally invasive techniques are increasingly utilized for WOPN management.
Endoscopic interventions have evolved significantly for treating WOPN.

Purpose of the Study:

To review and evaluate current interventional methodologies for WOPN.
To focus on endoscopic drainage and direct endoscopic necrosectomy (DEN).
To assess indications and optimal timing for endoscopic interventions in WOPN.

Main Methods:

Narrative review of existing literature on WOPN interventions.
Evaluation of endoscopic drainage techniques.
Analysis of direct endoscopic necrosectomy (DEN) procedures, including the role of lumen-apposing metal stents (LAMS).

Main Results:

Direct endoscopic necrosectomy (DEN) is emerging as a favored technique for WOPN.
Lumen-apposing metal stents (LAMS) facilitate DEN, especially for complex cases with solid debris or infection.
DEN demonstrates a lower rate of adverse events and shorter hospital stays.

Conclusions:

Endoscopic interventions, particularly DEN facilitated by LAMS, represent a highly effective treatment for WOPN.
DEN offers improved clinical outcomes and patient safety in managing WOPN.
Optimal timing and patient selection are crucial for successful endoscopic WOPN treatment.