Management of Hemorrhagic Walled-Off Necrosis Using the Multiple Transluminal Gateway Technique

Bang, Ji Young; Varadarajulu, Shyam

doi:10.1038/ajg.2016.70

Cited by 3 publications

(1 citation statement)

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“…Furthermore, Bang et al presented a successful case of MTGT using Axios stents. Using the single-step creation of tracts with Axios stents, MTGT has the potential to become essential to the framework of endoscopic management of WOPN [59][60][61]. However, larger, randomized studies are needed to validate these findings as limited studies are currently available.…”

Section: Multiple Transluminal Gateway Techniquementioning

confidence: 99%

Endoscopic Management of Pancreatic Fluid Collections

Dorrell

Pawa

2021

JCM

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Pancreatic fluid collections (PFCs) are a common sequela of pancreatitis. Most PFCs can be managed conservatively, but symptomatic PFCs require either surgical, percutaneous, or endoscopic intervention. Recent advances in the therapeutics of PFCs, including the step-up approach, endoscopic ultrasound-guided transmural drainage with lumen apposing metal stents, and direct endoscopic necrosectomy, have ushered endoscopy to the forefront of PFCs management and have allowed for improved patient outcomes and decreased morbidity. In this review, we explore the progress and future of endoscopic management of PFCs.

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Section: Multiple Transluminal Gateway Techniquementioning

confidence: 99%

Endoscopic Management of Pancreatic Fluid Collections

Dorrell

Pawa

2021

JCM

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Endoscopic Management of Infected Necrotizing Pancreatitis: an Evidence-Based Approach

Boxhoorn

Fockens

Besselink

et al. 2018

Curr Treat Options Gastro

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Purpose of ReviewEndoscopic management of infected necrotizing pancreatitis has evolved rapidly over the past years and there have been interesting innovations in this field. This review provides an update on the most recently published literature regarding endoscopic management of infected necrotizing pancreatitis.Recent FindingsA recent randomized trial demonstrated no difference in mortality and major morbidity between endoscopic and surgical step-up treatment of infected necrotizing pancreatitis. However, endoscopic therapy resulted in shorter hospital stay and less pancreatic fistulas. Various innovations have been investigated with the aim to further optimize endoscopic therapy, in particular lumen-apposing metal stents. While major stent-related complications were also reported, findings from recent studies indicated that their use was associated with higher resolution rates of walled-off necrosis compared to double-pigtail stents. Other innovations, such as the multiple gateway technique and dual-modality mode, can be considered for treatment of particular cases. Furthermore, research suggests that irrigation of walled-off necrosis can be performed by using a nasocystic tube and discontinuation of proton-pump inhibitors may be considered.SummaryEndoscopic treatment should be the preferred treatment modality in patients with infected necrotizing pancreatitis who are eligible for endoscopic drainage. Although data suggests that lumen-apposing metal stents are superior to double-pigtail stents, prospective multicenter studies focusing on safety as well as long-term follow-up are first needed.

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