Direct endoscopic necrosectomy: Pilot study of a new dedicated device

Area of Science:

• Gastroenterology
• Endoscopy
• Surgical Innovation

Background:

• Direct endoscopic necrosectomy (DEN) is the primary treatment for walled-off necrosis (WON).
• Current DEN methods lack dedicated devices, leading to significant adverse events and prolonged procedure times.
• A novel device, Necrolit, was developed to address these limitations.

Purpose of the Study:

• To evaluate the feasibility and safety of the Necrolit device for DEN.
• To compare Necrolit-assisted DEN with conventional DEN using non-dedicated devices.

Main Methods:

• A multicenter retrospective analysis involving 16 patients with WON treated with Necrolit.
• Comparison with a control group undergoing DEN with non-dedicated devices.
• Evaluation of technical success, adverse events, clinical success, procedure count, procedure time, and hospital stay.

Main Results:

• Technical success was achieved in 100% of patients in both groups.
• The Necrolit group had a lower adverse event rate (10.1%) compared to the control group (15.9%).
• Clinical success was higher in the Necrolit group (100%) versus the control group (81.3%).
• Patients treated with Necrolit required fewer procedures on average.

Conclusions:

• Direct endoscopic necrosectomy using the Necrolit device is a feasible and safe treatment option for WON.
• The Necrolit device demonstrates potential for improving outcomes in WON management.