title: Endoscopic drainage/debridement of walled-off pancreatic necrosis--single center experience of 112 cases.
abstract: BACKGROUND
  Endoscopic drainage of the pancreatic pseudocysts has been accepted as a valid alternative to surgical and percutaneous drainage. Endoscopic treatment of the symptomatic walled-off necrosis was not, however, univocally accepted by all authors.
  
  
  OBJECTIVE
  The aim of this study was to assessed the effectiveness and safety of the endoscopic drainage of walled-off necrosis.
  
  
  METHODS
  Between 2001 and 2011 one hundred and twelve patients with symptomatic walled-off necrosis were treated in the Department of Gastroenterology and Hepatology of the Medical University of Gdansk, using endoscopic drainage. The drainage system was set up by introducing endoprostheses and drains through gastric and duodenal fistulas, transpapillary, and additionally--in cases when the necrosis was spreading outside of the lesser sac--percutaneously. The results and complications of the endoscopic treatment were assessed retrospectively.
  
  
  RESULTS
  Initial success was achieved in 104/112 (92.9%) patients. Long term success was achieved in 94/112 (83.9%) patients in intention to treat analysis and 94/102 (90.4%) patients in per protocol analysis. Recurrence of pancreatic fluid collection was observed in 19/97(19.6%) patients. Procedure-related complications were observed in 29/112 patients (25.9%). Most of them were treated conservatively. Procedure-related mortality was 1.8%.
  
  
  CONCLUSIONS
  In a large group of selected patients with symptomatic walled-off necrosis, endoscopic drainage enables high success rate with acceptable complication rate and low procedure-related mortality.
authors.affiliation: Department of Gastroenterology and Hepatology of Medical University of Gdańsk, Gdańsk, Poland. Electronic address: kgastro@gumed.edu.pl.
authors.forename: M
authors.initials: M
authors.lastname: Smoczyński
authors.affiliation: Department of Gastroenterology and Hepatology of Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: I
authors.initials: I
authors.lastname: Marek
authors.affiliation: Department of Gastroenterology and Hepatology of Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Dubowik
authors.affiliation: Department of Gastroenterology and Hepatology of Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: G
authors.initials: G
authors.lastname: Rompa
authors.affiliation: Department of General, Endocrine and Transplant Surgery of Medical University of Gdańsk, Poland.
authors.forename: J
authors.initials: J
authors.lastname: Kobiela
authors.affiliation: Department of Radiology of Medical University of Gdańsk, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Studniarek
authors.affiliation: Department of Radiology of Medical University of Gdańsk, Poland.
authors.forename: J
authors.initials: J
authors.lastname: Pieńkowska
authors.affiliation: Department of Gastroenterology and Hepatology of Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: K
authors.initials: K
authors.lastname: Adrych
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003646:Debridement; D004322:Drainage; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D010192:Pancreatic Pseudocyst / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D019283:Pancreatitis, Acute Necrotizing / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Acute pancreatitis; Endoscopic drainage/debridement; Walled-off pancreatic necrosis