ハクタ　リユウノスケ   HAKUTA Riyuunosuke   白田　龍之介    所属   医学部 医学科（東京女子医科大学病院）    職種   講師
論文種別	原著
言語種別	英語
査読の有無	査読なし
表題	Controversies in endoscopic ultrasonography-guided management of walled-off necrosis
掲載誌名	正式名：Digestive endoscopy 略　 称：Dig Endosc ISSNコード：14431661/09155635
掲載区分	国外
巻・号・頁	37(1),pp.29-39
著者・共著者	NAKAI Yosuke, SAITO Tomotaka, HAMADA Tsuyoshi, SATO Tatsuya, HAKURA Ryunosuke, TAKAHARA Naminatsu, ISAYAMA Hiroyuki, YASUDA Ichiro, FUJISHIRO Mitsuhiro
発行年月	2025/01
概要	Walled-off necrosis (WON) develops as local complications after acute necrotizing pancreatitis. Although less invasive interventions such as endoscopic ultrasonography (EUS)-guided drainage and endoscopic necrosectomy are selected over surgical interventions, delayed and step-up interventions are still preferred to avoid procedure-related adverse events. However, there is a controversy about the appropriate timing of drainage and subsequent necrosectomy. The advent of large-caliber lumen-apposing metal stents has also brought about potential advantages of proactive interventions, which still needs investigation in future trials. When step-up interventions of necrosectomy and additional drainage are necessary, a structured or protocoled approach for WON has been reported to improve safety and effectiveness of endoscopic and/or percutaneous treatment, but has not been standardized yet. Finally, long-term outcomes such as recurrence of WON, pancreatic endocrine, and exocrine function are increasingly investigated in association with disconnected pancreatic duct syndrome. In this review we discuss current evidence and controversy on EUS-guided management of WON.
DOI	10.1111/den.14869
PMID	38895801