ArticleiGIE : innovation, investigation and insights2023
Endoscopic therapies for walled-off necrosis.
Article in iGIE : innovation, investigation and insights, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
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Corrections and comments
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Authors and funding
18 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background and Aims: Management of walled-off necrosis (WON) has focused on a step-up approach using minimally invasive drainage and debridement techniques. This document reviews the technical aspects of endoscopic management of WON, technical and clinical success, adverse event rates for endoscopic drainage, and dedicated endoscopic devices for direct endoscopic necrosectomy (DEN). Methods: The MEDLINE database was searched through April 2022 for relevant articles using the key words walled-off necrosis, endoscopic necrosectomy, interventional EUS, severe acute pancreatitis, necrotizing pancreatitis, and lumen-apposing metal stent. The manuscript was drafted by 2 authors and edited by members of the American Society for Gastrointestinal Endoscopy Technology Committee and subsequently by the American Society for Gastrointestinal Endoscopy Governing Board. Results: Multiple studies have demonstrated acceptable outcomes of primary cystenterostomy for drainage, performed with either plastic double-pigtail stents or fully covered self-expandable metal stents including lumen-apposing metal stents. Subsequent procedures for clearance of necrotic debris can be facilitated with hydrogen peroxide lavage, nasocystic flushing catheters, multiple transluminal gateway technique, dual-modality therapy, and novel DEN devices. Novel DEN devices include EndoRotor Powered Endoscopic Debridement (Interscope, Inc, Northbridge, Mass, USA), waterjet necrosectomy device, and the over-the-scope grasper (Ovesco AG, Tübingen, Germany). These devices were designed to reduce procedural time and the number of necrosectomy sessions for clearance of necrotic debris when compared with traditionally used devices such as polypectomy snares, biliary baskets, and retrieval nets. Conclusions: EUS-guided endoscopic drainage and debridement has become a well-established method for treatment of WON in a step-up paradigm. The use of adjunctive technologies requires further evaluation to define the optimal methods for WON treatment. Further improvements in dedicated DEN devices should lead to improved outcomes and more widespread utilization of endoscopic treatment options.
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.