ArticleDigestive diseases and sciences2026
Endoscopic Transmural Drainage of Walled-off Necrosis in Difficult Situations Using a Forward-Viewing Echoendoscope.
Article in Digestive diseases and sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionEndoscopic transmural drainage (ETD) using a therapeutic oblique-viewing echoendoscope is procedure of choice for symptomatic walled-off necrosis (WON). However, occasionally the procedure fails because of poor visualization, non-negotiation of proximal luminal narrowing, presence of intervening venous collaterals or difficult puncture because of oblique angle. In such situations, a forward-viewing echoendoscope (FVE) may offer technical advantages.
objectiveTo evaluate safety and efficacy of EUS-guided ETD of WON using a FVE in patients in whom drainage could not be completed using oblique-viewing echoendoscope.
methodsThe endoscopic database of a tertiary-care center was retrospectively reviewed and patients who underwent ETD of WON using a FVE following failure with a conventional oblique-viewing echoendoscope were identified. Demographic data, characteristics of WON, procedural details, technical success, and procedure-related adverse events were analyzed.
resultsTwenty-one patients (18 males; age range 12-54 years) underwent ETD using a FVE. The size of the WON ranged from 9 to 18 cm. Collections were located in the head (n = 2), body (n = 5), tail (n = 2), and body and tail (n = 12) of the pancreas. ETD was performed 5-24 weeks after an episode of acute necrotizing pancreatitis. Technical success was achieved in all patients (100%). Lumen-apposing metal stents were placed in 12 patients, multiple plastic stents in 7 patients, and a nasocystic drain in 2 patients. No immediate or early procedure-related complications or stent maldeployment were observed.
conclusionsETD of WON using an FVE is safe and effective in patients in whom drainage using a conventional oblique-viewing echoendoscope is technically challenging or unsuccessful.
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