ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2015
Cyst Gastrostomy and Necrosectomy for the Management of Sterile Walled-Off Pancreatic Necrosis: a Comparison of Minimally Invasive Surgical and Endoscopic Outcomes at a High-Volume Pancreatic Center.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 49 citations in OpenAlex.
- SAGES clinical practice guidelines for the management of symptomatic walled-off pancreatic necrosis.Surgical endoscopy · 2026Guideline
- SAGES systematic review and meta-analysis for the management of symptomatic walled-off pancreatic necrosis.Surgical endoscopy · 2026Pooled it
- Endoscopic versus laparoscopic drainage of pseudocyst and walled-off necrosis following acute pancreatitis: a randomized trial.Surgical endoscopy · 2020Trial
- When to Intervene in Acute Necrotizing Pancreatitis: A Narrative Review of the Optimal Timing for Intervention Strategies.Medicina (Kaunas, Lithuania) · 2024Review
- Article
- Robotic Cyst Gastrostomy and Roux-en-Y Cyst Jejunostomy for a Bilobed Walled-Off Pancreatic Necroma.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2022Article
- Effectiveness of digestive endoscopy and surgery in the treatment of necrotizing pancreatitis: a meta-analysis and systematic review.Gland surgery · 2021Article
- Comparison of Different Surgical Methods for Necrotizing Pancreatitis: A Meta-Analysis.Frontiers in surgery · 2021Article
- Turkish Gastroenterology Association, Pancreas Study Group, Chronic Pancreatitis Committee Consensus Report.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2020Article
- Endotherapy for pancreatic necrosis: An update.JGH open : an open access journal of gastroenterology and hepatology · 2019Review
- Robotic gastrointestinal surgery.Current problems in surgery · 2018Review
- Mortality and morbidity in necrotizing pancreatitis managed on principles of step-up approach: 7 years experience from a single surgical unit.World journal of gastrointestinal surgery · 2017Article
- Robotic transgastric cystgastrostomy and pancreatic debridement in the management of pancreatic fluid collections following acute pancreatitis.Journal of visualized surgery · 2016Review
- Discontinuation of proton pump inhibitor use reduces the number of endoscopic procedures required for resolution of walled-off pancreatic necrosis.Endoscopic ultrasoundArticle
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Authors and funding
11 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionWalled-off pancreatic necrosis (WON) is a sequela of acute necrotizing pancreatitis in 15-40% of cases. We sought to compare the outcomes of minimally invasive surgical and endoscopic cyst gastrostomy (CG) and necrosectomy for the management for sterile WON at a tertiary care high-volume pancreas center.
methodThis is a retrospective review of patients who underwent minimally invasive surgical or endoscopic CG and necrosectomy for clinically sterile WON between 2008 and 2013. Peri-procedural outcomes including costs were analyzed and compared.
resultsTwenty patients underwent minimally invasive surgical (robotic = 14, laparoscopic = 6) CG and necrosectomy, and 20 patients underwent endoscopic treatment. The surgical cohort had a larger median cyst size and higher CCI score. For the surgical cohort, median OR time was 167.5 min, estimated blood loss was 30 ml, and 65% underwent concomitant cholecystectomy. There was no mortality in either group and no difference in complication rates (20%). The failure rate was similar (15 versus 10%, P = 0.66). Although surgery was associated with a lower re-intervention rate (0 versus 1, P = 0.008), the endotherapy group was associated with shorter total LOS (inclusive of re-interventions) (7 versus 3 days, P = 0.032). The cost of the index procedure was significantly higher for the surgery group (P = 0.014); however, when considering all readmissions and re-interventions until resolution of the WON, the total cost was similar for both groups.
conclusionMinimally invasive surgical and endoscopic CG and necrosectomy are comparable treatments for sterile WON in terms of outcomes and overall cost. The surgical approach may be considered advantageous when a concomitant cholecystectomy is required.
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