Intraductal pancreatic stent fragmentation in patients with walled-off pancreatic necrosis and pancreatic duct disruption

Walled-off pancreatic necrosis.

Acute severe pancreatitits may be complicated by the development of 'walled-off pancreatic necrosis' (WOPN), which is characterised by a mixture of solid components and fluids on imaging studies as a consequence of organised pancreatic tissue necrosis. We present here an overview of the definition, clinical features, and diagnostic and therapeutic management of this clinical condition, which is...

Endoscopic Necrosectomy for Walled-Off Pancreatic Necrosis

Approximately 20% of patients with acute pancreatitis develop pancreatic necrosis with significant mortality. Surgical debridement is the traditional management of necrotizing pancreatitis, but it is associated with significant morbidity and mortality. Endoscopic necrosectomy using repeats session of debridement and stent insertion has been more frequently used within the last decade and half. ...

Walled-off pancreatic necrosis: where are we?

Walled-off pancreatic necrosis (WOPN) is a well-circumscribed area of necrosis which occurs as a late complication of acute pancreatitis, generally after four weeks from the initial attack. The term “walled-off necrosis” was introduced for the first time in 2006. Approximately 15% of patients with severe acute pancreatitis will develop a WOPN [1]. The impact of the onset of pancreatic necrosis ...

Intraductal necrosectomy for pancreatic walled-off necrosis using novel single-operator pancreatoscope.

A digital catheter-based single-operator cholangiopancreatoscope (SpyGlass DS Direct Visualization System; SPY DS, Boston Scientific) has recently become available. The scope of the SPY DS model shows marked improvements over the conventional SpyGlass system: (i) insertion into the biliary tract is easier because of the tapered tip; (ii) better visualization is obtained with the 120° digital fi...

Treatment of walled-off pancreatic necrosis: when and how?