Asian consensus statements on endoscopic management of walled‐off necrosis Part 1: Epidemiology, diagnosis, and treatment
Year: 2016
Type: article
Abstract: Walled-off necrosis (WON) is a relatively new term for encapsulated necrotic tissue after severe acute pancreatitis. Various terminologies such as pseudocyst, necroma, pancreatic abscess, and infected necrosis were previously used in the literature, resulting in confusion. The current and past terminologies must be reconciled to meaningfully interpret past data. Recently, endoscopic necrosectomy was introduced as a treatment option and is now preferred over surgical necrosectomy when the expertise is available. However, high-quality evidence is still lacking, and there is no standard management strategy for WON. The consensus meeting aimed to clarify the diagnostic criteria for WON and the role of endoscopic interventions in its management. In the Consensus Conference, 27 experts from eight Asian countries took an active role and examined key clinical aspects of WON diagnosis and endoscopic management. Statements were crafted based on literature review and expert opinion, employing the modified Delphi method. All statements were substantiated by the level of evidence and the strength of the recommendation. We created 27 consensus statements for WON diagnosis and management, including details of endoscopic procedures. When there was not enough solid evidence to support the statements, this was clearly acknowledged to facilitate future research. Proposed management strategies were formulated and are illustrated using flow charts. These recommendations, which are based on the best current scientific evidence and expert opinion, will be useful for guiding endoscopic management of WON. Part 1 of this statement focused on the epidemiology, diagnosis, and timing of intervention.
DOI: 10.1111/jgh.13394
Authors: Hiroyuki Isayama, Yousuke Nakai, Rungsun Rerknimitr, Christopher Khor, James Lau, Hsiu‐Po Wang, Dong Wan Seo, Thawee Ratanachu‐ek, Sundeep Lakhtakia, Tiing Leong Ang, Shomei Ryozawa, Tsuyoshi Hayashi, Hiroshi Kawakami, Natusyo Yamamoto, Takuji Iwashita, Fumihide Itokawa, Masaki Kuwatani, Masayuki Kitano, Keiji Hanada, Hirofumi Kogure, Tsuyoshi Hamada, Ryan Ponnudurai, Jong Ho Moon, Takao Itoi, Ichiro Yasuda, Atsushi Irisawa, Iruru Maetani
Institutions: The University of Tokyo, Chulalongkorn University, Singapore General Hospital, Chinese University of Hong Kong, Prince of Wales Hospital, National Taiwan University, National Taiwan University Hospital, Asan Medical Center, University of Ulsan, Rajavithi Hospital, Asian Institute of Gastroenterology, Changi General Hospital, Saitama International Medical Center, Saitama Medical University, Hokkaido University Hospital, Gifu University Hospital, Tokyo Medical University, Kindai University, Onomichi General Hospital, Soonchunhyang University, Soonchunhyang University Hospital Bucheon, Teikyo University Hospital, Mizonokuchi, Teikyo University, Fukushima Medical University, Fukushima Medical University Aizu Medical Center, Toho University Ohashi Medical Center
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2340260751