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Digestive Disease Interventions 2023; 07(04): 228-239
DOI: 10.1055/s-0043-1771306
Review Article

Walled-off Pancreatic Necrosis: Multidisciplinary Perspective

Keith B. Quencer
1   Charles Dotter Department of Interventional Radiology, Oregon Health and Science University, Portland, Oregon
,
Erin W. Gilbert
2   Division of Gastrointestinal and General Surgery, Department of Surgery, Oregon Health and Science University, Portland, Oregon
,
Leonardo Campos
1   Charles Dotter Department of Interventional Radiology, Oregon Health and Science University, Portland, Oregon
,
Emily R. Jonica
3   Division of Gastroenterology and Hepatology, Department of Medicine, Oregon Health and Science University, Portland, Oregon
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Abstract

Walled-off pancreatic necrosis is a potential sequela of necrotizing pancreatitis. When drainage is indicated, such as in the setting of local complications (biliary or bowel obstruction), superinfection, or the collection causing abdominal pain, endoscopic, percutaneous, and surgical approaches are possible. Endoscopic drainage with or without placement of a luminal apposing metal stent and possible direct endoscopic necrosectomy is the preferred approach for drainage given good outcomes and patient comfort. In some cases, due to location and/or lack of a mature wall, endoscopic drainage is not possible or may be ineffective. In such cases, percutaneous and/or surgical drainage may be necessary.

Keywords

necrotizing pancreatitis - walled-off pancreatic necrosis - luminal apposing metal stent - percutaneous drainage - video-assisted retroperitoneal debridement


Publication History

Received: 31 March 2023

Accepted: 12 June 2023

Article published online:
09 August 2023

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