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Endoscopic Interventions for Necrotizing Pancreatitis

The American Journal of Gastroenterology volume 109, pages 969981 (2014) | Download Citation

Abstract

Interventions for necrotizing pancreatitis have undergone a paradigm shift away from open surgical necrosectomy and toward minimally invasive techniques, with endoscopic transmural drainage (ETD) and necrosectomy emerging as principle forms of treatment. Recent multicenter studies, randomized trials, evidence-based guidelines, and consensus statements have endorsed the safety and efficacy of endoscopic and other minimally invasive techniques for the treatment of walled-off necrosis. A comprehensive review of indications, standard and novel approaches, outcomes, complications, and controversies regarding ETD and necrosectomy is presented. Given the inherent challenges and associated risks, endoscopic techniques for the management of necrotizing pancreatitis should be performed at specialized multidisciplinary centers by expert endoscopists well versed in the management of necrotizing pancreatitis.

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Affiliations

  1. Division of Gastroenterology, University of Minnesota, Minneapolis, Minnesota, USA

    • Guru Trikudanathan
    • , Rajeev Attam
    • , Mustafa A Arain
    • , Shawn Mallery
    •  & Martin L Freeman

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Competing interests

Guarantor of the article: Martin L. Freeman, MD, FACG.

Specific author contributions: All authors contributed equally to the manuscript.

Financial support: None.

Potential competing interests: Freeman has served as a consultant for Boston Scientific, received speaking honoraria from Cook Endoscopy, and has been an unpaid consultant to Hobbs Medical. The other authors declare no conflict of interest.

Corresponding author

Correspondence to Martin L Freeman.

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DOI

https://doi.org/10.1038/ajg.2014.130

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