There was no ability to achieve randomization since these patients were referred primarilyfor the presence of WOPN. This studywas unable to determine the benefits of endoscopic debridement compared with surgical debridement since most patients had survived the first four weeks of necrotizing pancreatitis prior to arrival at the referral hospital.
In conclusion, the creation of an extended cystogastrostomy followed by hydrogen peroxide irrigation was safe and feasible in endoscopic necrosectomy of WOPN and infected pseudocysts.
Sex Males: 13 Females: 6 Age (mean [+ or -] SD) 50 ([+ or -] 2.6) years Ethnicity NHW: 11 Hispanics: 8 Alcohol: 5 Etiology of pancreatitis Gallstone: 12 Idiopathic: 1 Postsurgical abscess: 1 Time from index AP to 9 ([+ or -] 2.2) intervention (mean weeks [+ or -] SD) WOPN: 7 Type of fluid collected Infected WOPN: 8 Infected pseudocyst: 3 Pancreatic abscess: 1 Approach Transgastric: 19 TABLE 2: Study outcomes.
The presence of necrotic tissues in an EUS image and morphology of an aspirate from the collection (dark brown color and fragments of necrotic tissues) confirmed the diagnosis of WOPN.
Excluded from the study were patients with WOPN who had no symptoms connected with the presence of pancreatic fluid collection (11 patients).
In the case of patients with symptomatic WOPN, transmural drainage was not performed if the distance between the collection wall and the gastrointestinal wall exceeded 15 mm in EUS.
When there was a clinical suspicion of WOPN infection, the use of antibiotics was prolonged and another microbial culture with antibiogram of necrotic collection contents was performed.
Endoscopic treatment was started in 101 patients with symptomatic WOPN. The etiology of acute pancreatitis was alcoholic in 61 patients and nonalcoholic in 40 (23: gallstones, 6: iatrogenic, 2: hypertriglyceridemia, and 9: idiopathic).
The WOPN infection was diagnosed on the basis of positive microbial culture in 31/101 (30.69%) patients.
The mean duration period of active drainage of WOPN was 23 (4-173) days.
Transmural stent migration into the WOPN cavity was stated in 3/101 (2.97%) patients.
During the follow-up, the recurrence of WOPN was observed in 9/101 (8.91%) patients.