RWON Study: The Real-World Walled-off Necrosis Study
Background/Aims The management of walled-off necrosis (WON) has undergone a paradigm shift from surgical to nonsurgical modalities. Real-world data on the management of symptomatic WON are scarce. Methods Prospectively collected data of symptomatic WON cases were retrospectively evaluated. The treat...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Society of Gastrointestinal Endoscopy
2021-11-01
|
| Series: | Clinical Endoscopy |
| Subjects: | |
| Online Access: | http://www.e-ce.org/upload/pdf/ce-2020-175.pdf |
| _version_ | 1797641266130845696 |
|---|---|
| author | Ankush Pawar Ujjwal Sonika Manish Kumar Sundeep Saluja Siddharth Srivastava |
| author_facet | Ankush Pawar Ujjwal Sonika Manish Kumar Sundeep Saluja Siddharth Srivastava |
| author_sort | Ankush Pawar |
| collection | DOAJ |
| description | Background/Aims The management of walled-off necrosis (WON) has undergone a paradigm shift from surgical to nonsurgical modalities. Real-world data on the management of symptomatic WON are scarce. Methods Prospectively collected data of symptomatic WON cases were retrospectively evaluated. The treatment modalities used were medical management alone, percutaneous catheter drainage (PCD) or endoscopic drainage (ED), or a combination of PCD and ED. We compared clinical outcome among these modalities. Results A total of 264 patients were evaluated. The most common indications for drainage were pain and fever. Of the patients, 28% was treated with medical therapy alone, 31% with ED, 37% with PCD, and 4% with a combined approach. Technical success and clinical success were achieved in 93% and 91% of patients in the endoscopic arm and in 90% and 81% patients in the PCD arm, respectively (p=0.0004 for clinical success). Lower rates of complications (7% vs. 22%, p=0.005), readmission (20% vs. 34%, p=0.04), and mortality (4% vs. 19%, p=0.0012), and shorter hospital stay (13 days vs. 19 days, p=0.0018) were observed in the endoscopic group than in the PCD group. Conclusions ED of WON is better than PCD and is associated with lower mortality, fewer complications, and shorter hospitalization. |
| first_indexed | 2024-03-11T13:43:05Z |
| format | Article |
| id | doaj.art-2d03535faf604bceafce10e358083e56 |
| institution | Directory Open Access Journal |
| issn | 2234-2400 2234-2443 |
| language | English |
| last_indexed | 2024-03-11T13:43:05Z |
| publishDate | 2021-11-01 |
| publisher | Korean Society of Gastrointestinal Endoscopy |
| record_format | Article |
| series | Clinical Endoscopy |
| spelling | doaj.art-2d03535faf604bceafce10e358083e562023-11-02T11:17:05ZengKorean Society of Gastrointestinal EndoscopyClinical Endoscopy2234-24002234-24432021-11-0154690991510.5946/ce.2020.1757478RWON Study: The Real-World Walled-off Necrosis StudyAnkush Pawar0Ujjwal Sonika1Manish Kumar2Sundeep Saluja3Siddharth Srivastava4 Department of Gastroenterology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India Department of Gastroenterology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India Department of Gastroenterology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India Department of Gastrosurgery, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India Department of Gastroenterology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, IndiaBackground/Aims The management of walled-off necrosis (WON) has undergone a paradigm shift from surgical to nonsurgical modalities. Real-world data on the management of symptomatic WON are scarce. Methods Prospectively collected data of symptomatic WON cases were retrospectively evaluated. The treatment modalities used were medical management alone, percutaneous catheter drainage (PCD) or endoscopic drainage (ED), or a combination of PCD and ED. We compared clinical outcome among these modalities. Results A total of 264 patients were evaluated. The most common indications for drainage were pain and fever. Of the patients, 28% was treated with medical therapy alone, 31% with ED, 37% with PCD, and 4% with a combined approach. Technical success and clinical success were achieved in 93% and 91% of patients in the endoscopic arm and in 90% and 81% patients in the PCD arm, respectively (p=0.0004 for clinical success). Lower rates of complications (7% vs. 22%, p=0.005), readmission (20% vs. 34%, p=0.04), and mortality (4% vs. 19%, p=0.0012), and shorter hospital stay (13 days vs. 19 days, p=0.0018) were observed in the endoscopic group than in the PCD group. Conclusions ED of WON is better than PCD and is associated with lower mortality, fewer complications, and shorter hospitalization.http://www.e-ce.org/upload/pdf/ce-2020-175.pdfdrainageendoscopic ultrasoundnecrosispancreatitisself-expandable metallic stent |
| spellingShingle | Ankush Pawar Ujjwal Sonika Manish Kumar Sundeep Saluja Siddharth Srivastava RWON Study: The Real-World Walled-off Necrosis Study Clinical Endoscopy drainage endoscopic ultrasound necrosis pancreatitis self-expandable metallic stent |
| title | RWON Study: The Real-World Walled-off Necrosis Study |
| title_full | RWON Study: The Real-World Walled-off Necrosis Study |
| title_fullStr | RWON Study: The Real-World Walled-off Necrosis Study |
| title_full_unstemmed | RWON Study: The Real-World Walled-off Necrosis Study |
| title_short | RWON Study: The Real-World Walled-off Necrosis Study |
| title_sort | rwon study the real world walled off necrosis study |
| topic | drainage endoscopic ultrasound necrosis pancreatitis self-expandable metallic stent |
| url | http://www.e-ce.org/upload/pdf/ce-2020-175.pdf |
| work_keys_str_mv | AT ankushpawar rwonstudytherealworldwalledoffnecrosisstudy AT ujjwalsonika rwonstudytherealworldwalledoffnecrosisstudy AT manishkumar rwonstudytherealworldwalledoffnecrosisstudy AT sundeepsaluja rwonstudytherealworldwalledoffnecrosisstudy AT siddharthsrivastava rwonstudytherealworldwalledoffnecrosisstudy |