Abstract

Endoscopic transmural drainage is usually performed for symptomatic well-encapsulated walled-off necrosis (WON) that usually develops in the delayed phase (> 4 weeks after disease onset) of acute necrotising pancreatitis (ANP). Endoscopic drainage is usually not advocated in the early (< 4 weeks after disease onset) stage of illness because of the risk of complications due to an incompletely formed encapsulating wall and poor demarcation of viable from necrotic tissue. However, emerging data from expert tertiary care centres over the last few years shows that the early endoscopic transluminal drainage approach is effective and safe. The development of lumen-apposing metal stents and better accessories for endoscopic necrosectomy has fuelled the expansion of indications of endoscopic drainage of pancreatic necrosis. However, early endoscopic drainage is associated with higher rates of adverse events; therefore, careful patient selection is paramount. This article will review the current indications, techniques and outcomes of early endoscopic transluminal drainage in pancreatic necrotic collections.

中文翻译：

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胰腺坏死的早期内镜干预：适应症、技术和结果

摘要

内镜透壁引流通常用于治疗有症状的包膜良好的壁状坏死 (WON)，这种坏死通常发生在急性坏死性胰腺炎 (ANP) 的延迟期（发病后 > 4 周）。通常不提倡在疾病早期（发病后 4 周内）进行内镜引流，因为由于包膜壁形成不完全以及活菌与坏死组织的分界不良而存在并发症的风险。然而，过去几年专家三级护理中心的新数据表明，早期内镜腔内引流方法是有效且安全的。腔内金属支架和更好的内镜坏死切除术附件的发展推动了内镜下胰腺坏死引流适应症的扩大。然而，早期内镜引流会导致较高的不良事件发生率；因此，仔细选择患者至关重要。本文将回顾目前胰腺坏死组织早期内镜腔内引流的适应症、技术和结果。