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Journals / Journal of Experimental and Clinical Medicine / 2026 / Volume: 42 Issue: 3

Endoscopic ultrasound-guided transluminal drainage and direct endoscopic necrosectomy in patients with walled-off necrosis

Omer Kucukdemırcı(Ondokuz Mayıs Üniversitesi Tıp Fakültesi)0000-0001-7642-2793
Ufuk Avcıoğlu(OMÜ)0000-0001-6905-4494
Ahmet Bektaş(OMÜ)0000-0001-7026-9353
Pages
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Publication Date
2025-09-30
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Prospective cohorts are warranted for further validation.

📌 3 Key Takeaways

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Objective & Hypothesis:Management of Walled-Off Necrosis (WON) poses a high mortality risk with a non-interventional approach.
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Key Findings & Data:This study retrospectively analyzed data from 18 patients (2016–2018) who underwent endoscopic ultrasound-guided cystogastrostomy, with 13 subsequently undergoing direct endoscopic necrosectomy (DEN) using lumen apposing metal stents (LAMS).
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Conclusion & Impact:Prospective cohorts are warranted for further validation.
🔬Design:Research Article
📍Scope:2016–2018 Verileri
⚙️Variables:Pancreatitis · Walled off necrosis · Full covered self-expandable stents

Abstract

Management of Walled-Off Necrosis (WON) poses a high mortality risk with a non-interventional approach. Minimally invasive techniques, including endoscopic ultrasound-guided cystogastrostomy with a step-up approach, have gained prominence. This study retrospectively analyzed data from 18 patients (2016–2018) who underwent endoscopic ultrasound-guided cystogastrostomy, with 13 subsequently undergoing direct endoscopic necrosectomy (DEN) using lumen apposing metal stents (LAMS). The insertion of cystogastrostomy stents was technically successful in all patients. Two patients experienced perforation following LAMS placement. Cyst size positively correlated with hospital stay duration. Between LAMS with pigtail (n=7) and without pigtail (n=6) groups, session numbers, stent duration, and hospital stay did not significantly differ, though numerical reductions were observed in pigtail cases. A moderate correlation existed between stent duration and amylase levels (r=-0.575, p=0.040). Percutaneous drainage catheters (PDC) were necessary in two patients without endoscopic access, and PDC patients had prolonged hospital stays. LAMS-supported EUS-DEN was a low-complication, high-success approach for symptomatic or infected WON. Perforation was identified as a severe complication. The addition of pigtail catheters within SEMS may positively impact session numbers, hospitalization duration, and stent residence time. Prospective cohorts are warranted for further validation.

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Cite This Article

Kucukdemırcı, O., Avcıoğlu, U., Bektaş, A. (2025). Endoscopic ultrasound-guided transluminal drainage and direct endoscopic necrosectomy in patients with walled-off necrosis. Journal of Experimental and Clinical Medicine, Volume: 42 Issue: 3. https://ajindex.com/articles/1422563

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