TY - JOUR
T1 - Clinical outcome of endoscopic treatment for symptomatic sterile walled-off necrosis
AU - Boxhoorn, Lotte
AU - Fritzsche, Jeska A.
AU - Fockens, Paul
AU - van Hooft, Jeanin E.
AU - de Jonge, Pieter J. F.
AU - Poley, Jan-Werner
AU - Bruno, Marco J.
AU - Voermans, Rogier P.
N1 - Funding Information: Dr. Fockens has received research support from Boston Scientific and personal fees from Cook Medical, Ethicon Endo-Surgery, and Olympus. Dr. Poley has received speaker fees and has acted as a consultant for Cook Medical, Boston Scientific, and Pentax. Dr. van Hooft has received research support from Cook Medical and Mylan, and has acted as a consultant for Metronics and Boston Scientific. Dr. Bruno has received research support from Boston Scientific, Cook Medical, Pentax, and 3M, and has acted as a consultant for Boston Scientific, Cook Medical, Pentax, and Mylan. Dr. Voermans has received research support from Boston Scientific and has acted as a consultant for Boston Scientific. Drs. Boxhoorn, Drs. Fritzsche, and Dr. de Jonge declare that they have no conflicts of interest. Publisher Copyright: © 2021 Georg Thieme Verlag. All rights reserved. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/2/1
Y1 - 2021/2/1
N2 - Background The majority of patients with symptomatic sterile walled-off necrosis (WON) can be treated conservatively. Although endoscopic transluminal drainage (ETD) is often performed in cases of persistent symptoms, post-procedural iatrogenic infection may occur. This study aimed to evaluate clinical outcomes after ETD of symptomatic sterile WON. Methods This was a retrospective, multicenter, open-label case series of 56 patients with necrotizing pancreatitis who underwent ETD for symptomatic sterile WON between July 2001 and August 2018at two tertiary referral hospitals. Primary end point was clinically relevant post-procedural iatrogenic infection, defined as need for endoscopic transluminal necrosectomy. Secondary end points included mortality, total number of interventions, hospital stay, and resolution of symptoms at 1-year follow-up. Results ETD of sterile WON was performed in 56 patients (median age 55 years, 57% male), who presented with abdominal pain (71%), gastric outlet obstruction (45%), jaundice (20%), and failure to thrive (27%). A total of 41 patients (73%) developed clinically relevant post-procedural iatrogenic infection, resulting in a median of 3 (interquartile range [IQR] 2-4) endoscopic, radiological, and/or surgical interventions. Mortality rate was 2%. Median total hospital stay was 12 days (IQR 6-17). Resolution of symptoms was reported in 40 of 46 patients (87%) for whom long-term follow-up data were available (median follow-up 13 months, IQR 6-29). Conclusions ETD of symptomatic sterile WON resulted in high clinical success. Nonetheless, the majority of patients required additional reinterventions for clinically relevant post-procedural iatrogenic infection.
AB - Background The majority of patients with symptomatic sterile walled-off necrosis (WON) can be treated conservatively. Although endoscopic transluminal drainage (ETD) is often performed in cases of persistent symptoms, post-procedural iatrogenic infection may occur. This study aimed to evaluate clinical outcomes after ETD of symptomatic sterile WON. Methods This was a retrospective, multicenter, open-label case series of 56 patients with necrotizing pancreatitis who underwent ETD for symptomatic sterile WON between July 2001 and August 2018at two tertiary referral hospitals. Primary end point was clinically relevant post-procedural iatrogenic infection, defined as need for endoscopic transluminal necrosectomy. Secondary end points included mortality, total number of interventions, hospital stay, and resolution of symptoms at 1-year follow-up. Results ETD of sterile WON was performed in 56 patients (median age 55 years, 57% male), who presented with abdominal pain (71%), gastric outlet obstruction (45%), jaundice (20%), and failure to thrive (27%). A total of 41 patients (73%) developed clinically relevant post-procedural iatrogenic infection, resulting in a median of 3 (interquartile range [IQR] 2-4) endoscopic, radiological, and/or surgical interventions. Mortality rate was 2%. Median total hospital stay was 12 days (IQR 6-17). Resolution of symptoms was reported in 40 of 46 patients (87%) for whom long-term follow-up data were available (median follow-up 13 months, IQR 6-29). Conclusions ETD of symptomatic sterile WON resulted in high clinical success. Nonetheless, the majority of patients required additional reinterventions for clinically relevant post-procedural iatrogenic infection.
UR - http://www.scopus.com/inward/record.url?scp=85091755016&partnerID=8YFLogxK
U2 - https://doi.org/10.1055/a-1198-7501
DO - https://doi.org/10.1055/a-1198-7501
M3 - Article
C2 - 32531781
SN - 0013-726X
VL - 53
SP - 136
EP - 144
JO - Endoscopy
JF - Endoscopy
IS - 2
ER -