RWON Study: The Real-World Walled-off Necrosis Study
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Background/Aims: The management of walled-off necrosis (WON) has undergone a paradigm shift from surgical to nonsurgicalmodalities. 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 usedwere medical management alone, percutaneous catheter drainage (PCD) or endoscopic drainage (ED), or a combination of PCD andED. 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 successand 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 endoscopicgroup than in the PCD group. Conclusions: ED of WON is better than PCD and is associated with lower mortality, fewer complications, and shorter hospitalization.
Abstract
Background/Aims: The management of walled-off necrosis (WON) has undergone a paradigm shift from surgical to nonsurgicalmodalities. 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 usedwere medical management alone, percutaneous catheter drainage (PCD) or endoscopic drainage (ED), or a combination of PCD andED. 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 successand 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 endoscopicgroup than in the PCD group. Conclusions: ED of WON is better than PCD and is associated with lower mortality, fewer complications, and shorter hospitalization.
참고문헌 (35)
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