Timing of Endoscopic Necrosectomy Following Transmural Stent Placement for Pancreatic Necrosis.

Abstract

Pancreatic walled-off necrosis (WON) may require adjunctive direct endoscopic necrosectomy (DEN) following transmural stent placement. DEN is performed immediately or delayed in relation to index endoscopy. There is currently no consensus on the optimal timing of DEN. We review the most recent literature addressing each practice. Some expert opinion prefer delayed DEN; however, recent data reveal immediate DEN may reduce the number of endoscopic sessions required for successful clinical resolution of WON. Future studies are needed to determine the optimal timing for DEN following transmural stent placement for the management of WON.