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Long-term Outcomes of Direct Endoscopic Necrosectomy for Complicated or Symptomatic Walled-Off Necrosis: A Korean Multicenter Study
DC Field | Value | Language |
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dc.contributor.author | 조재희 | - |
dc.date.accessioned | 2021-12-28T16:40:10Z | - |
dc.date.available | 2021-12-28T16:40:10Z | - |
dc.date.issued | 2021-11 | - |
dc.identifier.issn | 1976-2283 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/186741 | - |
dc.description.abstract | Background/aims: The endoscopic step-up approach is accepted as the preferred treatment for complicated or symptomatic walled-off necrosis (WON). Direct endoscopic necrosectomy (DEN) is an effective therapeutic option, but few reports describe long-term follow-up in this patient population. Thus, we aim to assess the long-term outcomes of DEN following severe necrotizing pancreatitis. Methods: The data of all acute pancreatitis patients who underwent DEN following endoscopic transmural drainage from six referral centers between 2007 and 2017 were retrospectively collected. Results: Sixty patients (76.7% male, mean age 48.3 years) underwent a median of 4 sessions of DEN starting at a median of 45.5 days after the onset of acute pancreatitis. Clinical success was achieved in 51 patients (85%), with a 35% complication rate and a 5% mortality rate. Using multivariate analysis, the risk factor associated with DEN failure or major DEN complications requiring intervention or surgery was an identified bacterial/fungal WON infection (odds ratio, 19.3; 95% confidence interval, 1.5 to 261.7). During the median follow-up period of 27 months, complicated WON recurrence was observed in 5.3% of patients, and long-term complications occurred in 24.6% of patients (four exocrine insufficiency, nine newly developed diabetes mellitus, one recurrent small bowel obstruction, one chylous ascites). Conclusions: Considering that long-term complications are similar to those observed after pancreatectomy, DEN should be performed meticulously while minimizing damage to the viable pancreatic parenchyma with adequate antibiotic escalation. | - |
dc.description.statementOfResponsibility | open | - |
dc.language | English | - |
dc.publisher | Editorial Office of Gut and Liver | - |
dc.relation.isPartOf | GUT AND LIVER | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.subject.MESH | Acute Disease | - |
dc.subject.MESH | Drainage | - |
dc.subject.MESH | Female | - |
dc.subject.MESH | Humans | - |
dc.subject.MESH | Male | - |
dc.subject.MESH | Middle Aged | - |
dc.subject.MESH | Necrosis | - |
dc.subject.MESH | Pancreatitis, Acute Necrotizing* / surgery | - |
dc.subject.MESH | Republic of Korea | - |
dc.subject.MESH | Retrospective Studies | - |
dc.subject.MESH | Stents* | - |
dc.subject.MESH | Treatment Outcome | - |
dc.title | Long-term Outcomes of Direct Endoscopic Necrosectomy for Complicated or Symptomatic Walled-Off Necrosis: A Korean Multicenter Study | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Internal Medicine (내과학교실) | - |
dc.contributor.googleauthor | Yeon Suk Kim | - |
dc.contributor.googleauthor | Jae Hee Cho | - |
dc.contributor.googleauthor | Dong Hui Cho | - |
dc.contributor.googleauthor | Se Woo Park | - |
dc.contributor.googleauthor | Sung-Hoon Moon | - |
dc.contributor.googleauthor | Jin-Seok Park | - |
dc.contributor.googleauthor | Yun Nah Lee | - |
dc.contributor.googleauthor | Sang Soo Lee | - |
dc.identifier.doi | 10.5009/gnl20304 | - |
dc.contributor.localId | A03902 | - |
dc.relation.journalcode | J00954 | - |
dc.identifier.eissn | 2005-1212 | - |
dc.identifier.pmid | 33767033 | - |
dc.subject.keyword | Acute pancreatitis | - |
dc.subject.keyword | Antibiotics | - |
dc.subject.keyword | Endoscopy | - |
dc.subject.keyword | Infected necrosis | - |
dc.subject.keyword | Necrosectomy | - |
dc.contributor.alternativeName | Cho, Jae Hee | - |
dc.contributor.affiliatedAuthor | 조재희 | - |
dc.citation.volume | 15 | - |
dc.citation.number | 6 | - |
dc.citation.startPage | 930 | - |
dc.citation.endPage | 939 | - |
dc.identifier.bibliographicCitation | GUT AND LIVER, Vol.15(6) : 930-939, 2021-11 | - |
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