Endoscopic therapy for organized pancreatic necrosis

Area of Science:

• Gastroenterology
• Interventional Endoscopy
• Pancreatic Diseases

Background:

• Treatment for extensive pancreatic necrosis is debated.
• Organized collections can form in severe acute necrotizing pancreatitis.
• This study assesses endoscopic drainage feasibility for organized pancreatic necrosis.

Observation:

• 11 patients with organized pancreatic necrosis underwent endoscopic drainage.
• Dynamic contrast-enhanced CT confirmed >50% pancreatic necrosis in 10 patients.
• 8 patients received intrapancreatic nasobiliary lavage catheters with 10F stents.

Findings:

• Complete resolution occurred nonoperatively in 9 patients.
• One patient developed a pseudocyst requiring endoscopic drainage.
• Complications, including bleeding, occurred in 5 patients.

Implications:

• Endoscopic therapy is a viable option for select symptomatic patients with organized pancreatic necrosis.
• Intrapancreatic lavage catheter placement is crucial for success.
• Further research is needed before widespread clinical adoption.