Ramai Daryl, Morgan Amanda D, Gkolfakis Paraskevas, Facciorusso Antonio, Chandan Saurabh, Papaefthymiou Apostolis, Morris John, Arvanitakis Marianna, Adler Douglas G
Gastroenterology & Hepatology, University of Utah Health, Salt Lake City, UT, USA (Daryl Ramai, John Morris).
Rocky Vista University, Ivins, UT, USA (Amanda D. Morgan).
Ann Gastroenterol. 2023 Mar-Apr;36(2):123-131. doi: 10.20524/aog.2023.0772. Epub 2023 Jan 4.
Pancreatic walled-off necrosis (WON) is a complication of severe pancreatitis. Endoscopic transmural drainage has been recognized as the first-line treatment for pancreatic fluid collections. Endoscopy offers a minimally invasive approach when compared to surgical drainage. Today, endoscopists may choose to use self-expanding metal stents, pigtail stents, or lumen-apposing metal stents to facilitate drainage of fluid collections. Current data suggest that all 3 approaches yield similar outcomes. It was previously thought that drainage should be performed 4 weeks from the initial event of pancreatitis, theoretically allowing the capsule to mature. However, current data show that both early (<4 weeks) and standard (≥4 weeks) endoscopic drainage are comparable. Herein, we provide an up-to-date state-of-the-art review of the indications, techniques, innovations, outcomes, and future perspectives following drainage of pancreatic WON.
胰腺包裹性坏死（WON）是重症胰腺炎的一种并发症。内镜下经壁引流已被公认为胰腺液体积聚的一线治疗方法。与手术引流相比，内镜检查提供了一种微创方法。如今，内镜医师可选择使用自膨式金属支架、猪尾支架或管腔贴附金属支架来促进液体积聚的引流。目前的数据表明，这三种方法产生的结果相似。以前认为应在胰腺炎初始事件发生4周后进行引流，理论上可使包膜成熟。然而，目前的数据显示，早期（<4周）和标准（≥4周）内镜引流效果相当。在此，我们提供了一篇关于胰腺WON引流后的适应症、技术、创新、结果及未来展望的最新技术综述。
