BACKGROUND AND STUDY AIMS: Direct percutaneous endoscopic necrosectomy has been described as a minimally invasive intervention for the debridement of @entity39 ( @entity39 ). In this retrospective cohort study, we aimed to confirm these findings in a US referral center and evaluate the clinical value of this modality in the treatment of @entity39 as well as other types of intra-abdominal fluid collections and @entity39 . @entity1 AND METHODS: Twelve consecutive @entity1 with @entity39 or other @entity6177 requiring debridement and washout underwent computed tomography (CT)-guided drainage catheter placement. Each @entity1 then underwent direct percutaneous endoscopic necrosectomy and washout with repeat debridement performed until complete. Drains were then removed once output fell below 30mL/day and imaging confirmed resolution. The primary endpoints were time to clinical resolution and sustained resolution at 1-year follow up. RESULTS: Ten @entity1 were treated for @entity39 , one for @entity99 , and one for omental @entity39 . The median time to intervention was 85 days with an average of 2.3 necrosectomies performed. Complete removal of drains was accomplished in 11 @entity1 (92%). The median time to resolution was 57 days. No serious adverse events occurred; however, one @entity1 developed pancreaticocutaneous @entity292 . Ten @entity1 completed 1-year surveillance of which none required drain replacement. No @entity1 required surgery or repeat endoscopy. CONCLUSIONS: This series supports the premise that direct percutaneous endoscopic necrosectomy is a safe and effective intervention for intra-abdominal fluid collections and @entity39 in appropriately selected @entity1 . Our study demonstrates a high clinical success rate with minimal adverse events. This modality offers several potential advantages over surgical and transgastric approaches including use of improved accessibility, an excellent safety profile, and requirement for only deep or moderate sedation.

Percutaneous debridement and washout of walled-off @entity6177 and XXXX using flexible endoscopy: a large single-center experience.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'PATIENTS'] @entity39 :: ('MESH:D009336', 'Disease') :: ['necrosis', 'walled-off pancreatic necrosis', 'WOPN', 'pancreatic necrosis'] @entity6177 :: ('MESH:D018784', 'Disease') :: ['abdominal abscess'] @entity292 :: ('MESH:D005402', 'Disease') :: ['fistulas'] @entity99 :: ('MESH:D056486', 'Disease') :: ['necrotic hepatic abscesses']
@entity39 :: (MESH:D009336,Disease) :: ['necrosis']
