Journal of Experimental and Clinical SurgeryJournal of Experimental and Clinical SurgeryВестник экспериментальной и клинической хирургии2070-478X2409-143XVoronezh State Medical University named after N.N. Burdenko160910.18499/2070-478X-2022-15-2-165-173Review of literatureОбзор литературыResearch ArticlePotential of Minimally Invasive Drainage Interventions for Acute PancreatitisВарианты миниинвазивных дренирующих вмешательств при остром панкреатитеFedorovAndrey VladimirovichФедоровАндрей Владимирович
Russian Federation

M.D., Professor of the Department of Endoscopic Surgery of the Moscow State Medical and Dental University named after A.I. Evdokimov, Secretary General of the Russian Society of Surgeons

д.м.н., профессор кафедры эндоскопической хирургии Московского государственного медико-стоматологического университета им. А.И. Евдокимова, генеральный секретарь Российского общества хирургов

A.Fedorov@surgeons.ruEktovVladimir NikolaevichЭктовВладимир Николаевич
Russian Federation

M.D., Professor, Head of the Department of Surgical Disciplines, Voronezh State Medical University named after N.N.Burdenko

д.м.н., профессор, заведующий кафедрой хирургических дисциплин ИДПО, Воронежский государственный медицинский университет им.Н.Н.Бурденко

ektov.vladimir@yandex.ruKhodorkovskyMark AnatolyevichХодорковскийМарк Анатольевич
Russian Federation

M.D., Professor of the Department of Surgical Disciplines, Voronezh State Medical University named after N.N.Burdenko

д.м.н., профессор кафедры хирургических дисциплин ИДПО, Воронежский государственный медицинский университет им.Н.Н.Бурденко

v.jektov@vrvgmu.ruSkoryninOleg SergeevichСкорынинОлег Сергеевич
Russian Federation

Ph.D., Associate Professor of the Department of Surgical Disciplines, Voronezh State Medical University named after N.N.Burdenko

к.м.н., доцент кафедры хирургических дисциплин ИДПО, Воронежский государственный медицинский университет им.Н.Н.Бурденко

skorynin.sergey@mail.ruMoscow State Medical and Dental University named after A.I. EvdokimovМосковский государственный медико-стоматологический университет им. А.И. ЕвдокимоваVoronezh State Medical University named after N.N.BurdenkoВоронежский государственный медицинский университет им.Н.Н.Бурденко0611202215216517323062022Copyright ©; 2022, Voronezh N.N. Burdenko State Medical UniversityCopyright ©; 2022, ФГБОУ ВО ВГМУ им. Н.Н. Бурденко Минздрава России2022Voronezh N.N. Burdenko State Medical UniversityФГБОУ ВО ВГМУ им. Н.Н. Бурденко Минздрава Россииhttps://vestnik-surgery.com/journal/about/editorialPolicieshttps://vestnik-surgery.com/journal/article/view/1609

The article reviews literature data on the potential use of minimally invasive drainage interventions in the treatment of acute necrotizing pancreatitis. Detailed information is provided on the terminology, indications and technical features of the main types of drainage interventions - percutaneous and endoscopic transluminal drainage. The results of numerous studies evaluating drainage effectiveness and possible combined applications are presented. The article also focuses on the current international clinical guidelines evidencing advisability of minimally invasive drainage interventions as part of a phased intervention strategy for the treatment of infected necrotizing pancreatitis.

В обзоре представлены данные литературы о возможностях применения миниинвазивных дренирующих вмешательств в лечении острого некротизирующего панкреатита. Подробно изложена информация о терминологии, показаниях и технических особенностях выполнения основных типов дренирующих вмешательств - чрескожного и эндоскопического транслюминального дренирования. Представлены результаты многочисленных исследований по оценке их эффективности и возможным комбинированным вариантам применения. Приведены материалы актуальных международных клинических рекомендаций, свидетельствующие о целесообразности выполнения миниинвазивных дренирующих вмешательств в рамках поэтапной интервенционной стратегии лечения инфицированного некротизирующего панкреатита.

infected necrotizing pancreatitispercutaneous drainageendoscopic transluminal drainageинфицированный некротизирующий панкреатитчрескожный дренажэндоскопический транслюминальный дренажVan Brunschot S, van Grinsven J, van Santvoort HC. Endoscopic or surgical step-up approach for infected necrotising pancreatitis: a multicentre randomized trial. Lancet. 2018;391:51–58.Haney CM, Kowalewski KF, Schmidt MW, Koschny R, Felinska EA, Kalkum E, Probst P, Diener MK, Müller-Stich BP, Hackert T, Nickel F. Endoscopic versus surgical treatment for infected necrotizing pancreatitis: a systematic review and meta-analysis of randomized controlled trials.Surg Endosc. 2020; 34(6): 2429-2444. doi: 10.1007/s00464-020-07469-9Arvanitakis М, Dumonceau JM, Albert J. Endoscopic management of acute necrotizing pancreatitis:European Society of Gastrointestinal Endoscopy (ESGE) evidence-based multidisciplinary guidelines. Endoscopy. 2018; 50: 524-546. doi.org/10.1055/a-0588-5365Leppäniemi A, Tolonen M, Tarasconi А.2019 WSES guidelines for the management of severe acute pancreatitis. World Journal of Emergency Surgery. 2019; 14: 27. doi.org/10.1186/s13017-019-0247-0Working Group IAP/APA. Acute Pancreatitis Guidelines. IAP/APA evidence-based guidelines for the management of acute pancreatitis. Pancreatology. 2013; 13: 4(2): 15.Klinicheskie rekomendatsii: Ostryi pankreatit. Rossiiskoe obshchestvo khirurgov Assotsiatsiya gepatopankreatobiliarnykh khirurgov stran SNG. 2015; 38. (in Russ.)Клинические рекомендации: Острый панкреатит. Российское общество хирургов Ассоциация гепатопанкреатобилиарных хирургов стран СНГ. 2015; 38.Yokoe M, Takada T, Mayumi T, et al. Japanese guidelines for the management of acute pancreatitis: Japanese Guidelines 2015. J Hepatobiliary Pancreat Sci. 2015; 22: 405–432.Baron T, DiMaio Ch, Wang A, Morgan K. American gastroenterological association clinical practice update: management of pancreatic necrosis. Gastroenterology. 2020; 158:67–75Lee PJ, Papachristou GI. Management of severe acute pancreatitis Curr Treat Options Gastro. 2020. DOI 10.1007/s11938-020-00322-xBoxhoorn L, van Dijk SM, van Grinsven J. Dutch Pancreatitis Study Group. Immediate versus Postponed Intervention for Infected Necrotizing Pancreatitis. N Engl J Med. 2021; 385 (15): 1372-1381. doi: 10.1056/NEJMoa2100826Qu C, Zhang H, Chen T, Zhu Y.Chinese Acute Pancreatitis Clinical Trials Group (CAPCTG). Early on-demand drainage versus standard management among acute necrotizing pancreatitis patients complicated by persistent organ failure: The protocol for an open-label multi-center randomized controlled trial. Pancreatology. 2020;20(7):1268-1274. doi: 10.1016/j.pan.2020.08.012Brunschot S,  Bakker O,  Besselink M. Treatment of necrotizing pancreatitis. Clin Gastroenterol Hepatol. 2012; 10 (11): 1190-201. doi: 10.1016/j.cgh.2012.05.005Andreev AV, Ivshin VG, Goltsov VR. Minimally invasive interventions for infected pancreatic necrosis. Annaly khirurgicheskoi gepatologii. 2015; 20 (3): 110-116. DOI: 10.16931/1995-5464.20153110-116. (in Russ.)Андреев А.В., Ившин В.Г., Гольцов В.Р. Лечение инфицированного панкреонекроза с помощью миниинвазивных вмешательств. Анналы хирургической гепатологии. 2015; 20: 3: 110-116. DOI: 10.16931/1995-5464.20153110-116.Baal MC, van Santvoort HC, Bollen TL et al. Systematic review of percutaneous catheter drainage as primary treatment for necrotizing pancreatitis. Br J Surg. 2011; 98: 18 – 27Gluck M, Ross A, Irani S. Dual modality drainage for symptomatic walled-off pancreatic necrosis reduces length of hospitalization, radiological procedures and number of endoscopies compared to standard percutaneous drainage. J Gastrointest Surg. 2012; 16: 248 – 257Horvath K, Freeny P, Escallon J, Heagerty P, Comstock B, Glickerman DJ. Safety and efficacy of video-assisted retroperitoneal debridement for infected pancreatic collections: a multicenter, prospective, single-arm phase 2 study. Arch Surg. 2010; 145: 817e25.Besselink M, Hjalmar C van Santvoort H, Vincent B Nieuwenhuijs V. Minimally invasive 'step-up approach' versus maximal necrosectomy in patients with acute necrotising pancreatitis (PANTER trial): design and rationale of a randomised controlled multicenter trial [ISRCTN38327949]. BMC Surg. 2006; 6: 6. doi: 10.1186/1471-2482-6-6Van Santvoort HC, Besselink MG, Bakker OJ, Hofker HS, Boermeester MA, Dejong CH. A step-up approach or open necrosectomy for necrotizing pancreatitis. NEnglJMed. 2010; 362: 1491-502.Nemoto Y, Attam R, Arain MA. Interventions for walled off necrosis using an algorithm based endoscopic step-up approach: outcomes in a large cohort of patients. Pancreatology. 2017;17:663–668.Bang JY, Holt BA, Hawes RH. Outcomes after implementing a tailored endoscopic step-up approach to walled-off necrosis in acute pancreatitis. Br J Surg. 2014;101:1729–1738.Ross AS, Irani S, Gan SI. Dual-modality drainage of infected and symptomatic walled-off pancreatic necrosis: long-term clinical outcomes. GastrointestEndosc. 2014;79:929–935.Galliamov ÉA, Agapov MA, Busyrev YuB. Comparison of minimal invasive technologies for treatment of infected pancreatic necrosis. Khirurgiya. 2020;(3):22-28.Галлямов Э.А., Агапов М.А., Бусырев Ю.Б. Сравнительная оценка минимально инвазивных методик лечения инфицированного панкреонекроза. Хирургия. Журнал им. Н.И. Пирогова. 2020;(3): 22-28DOI:10.17116/hirurgia202003122.https://doi.org/10.17116/hirurgia202003122.Zhang ZH, Ding YX, Wu YD, Gao CC, Li F. A meta-analysis and systematic review of percutaneous catheter drainage in treating infected pancreatitis necrosis. Medicine (Baltimore). 2018 Nov;97(47): e12999. doi: 10.1097/MD.0000000000012999Zhang ZH, Ding YX, Wu YD, Gao CC, Li F. A meta-analysis and systematic review of percutaneous catheter drainage in treating infected pancreatitis necrosis. Medicine (Baltimore). 2018 Nov;97(47): e12999. doi: 10.1097/MD.0000000000012999Shenvi S, Gupta R, Kang M. Timing of surgical intervention in patients of infected necrotizing pancreatitis not responding to percutaneous catheter drainage. Pancreatology. 2016; 16: 778– 787Shenvi S, Gupta R, Kang M. Timing of surgical intervention in patients of infected necrotizing pancreatitis not responding to percutaneous catheter drainage. Pancreatology. 2016; 16: 778– 787Babu RY, Gupta R, Kang M et al. Predictors of surgery in patients with severe acute pancreatitis managed by the step-up approach. Ann Surg. 2013; 257: 737 – 750Babu RY, Gupta R, Kang M et al. Predictors of surgery in patients with severe acute pancreatitis managed by the step-up approach. Ann Surg. 2013; 257: 737 – 750Hollemans R, Bollen T, van Brunscht S. Predicting success of catheter drainage in infected necrotizing hancreatitis. Ann Surg. 2015;00:1–6 DOI: 10.1097/SLA.0000000000001203Hollemans R, Bollen T, van Brunscht S. Predicting success of catheter drainage in infected necrotizing hancreatitis. Ann Surg. 2015;00:1–6 DOI: 10.1097/SLA.0000000000001203Baron TH, Thaggard WG, Morgan DE. Endoscopic therapy for organized pancreatic necrosis. Gastroenterology 1996;111:755–764Baron TH, Thaggard WG, Morgan DE. Endoscopic therapy for organized pancreatic necrosis. Gastroenterology 1996;111:755–764Vilmann A, Menachery J, Tang S, Srinivasan I, Vilmann P. EUS-guided management of pancreatic fluid collections.World J Gastroenterol. 2015; 21(41): 11842-11853 DOI: 10.3748/wjg.v21.i41.11842Vilmann A, Menachery J, Tang S, Srinivasan I, Vilmann P. EUS-guided management of pancreatic fluid collections.World J Gastroenterol. 2015; 21(41): 11842-11853 DOI: 10.3748/wjg.v21.i41.11842Baron TH, Kozarek RA. Endotherapy for organized pancreatic necrosis: perspectives after 20 years. ClinGastroenterol Hepatol. 2012;10:1202–1207Baron TH, Kozarek RA. Endotherapy for organized pancreatic necrosis: perspectives after 20 years. ClinGastroenterol Hepatol. 2012;10:1202–1207Varadarajulu S, Tamhane A, Blakely J. Graded dilation technique for EUS-guided drainage of peripancreatic fluid collections: an assessment of out comes and complications and technical proficiency (with video). GastrointestEndosc. 2008; 68: 656 – 666Varadarajulu S, Tamhane A, Blakely J. Graded dilation technique for EUS-guided drainage of peripancreatic fluid collections: an assessment of out comes and complications and technical proficiency (with video). GastrointestEndosc. 2008; 68: 656 – 666Mukai S, Itoi T, Sofuni A. Expanding endoscopic interventions for pancreatic pseudocyst and walled-off necrosis. J Gastroenterol. 2015; 50: 211 – 220Mukai S, Itoi T, Sofuni A. Expanding endoscopic interventions for pancreatic pseudocyst and walled-off necrosis. J Gastroenterol. 2015; 50: 211 – 220Mukai S, Itoi T, Sofuni A, Itokawa F, Kurihara T, Tsuchiya T, Ishii K, Tsuji S, Ikeuchi N, Tanaka R. Novel single transluminal gateway transcystic multiple drainages after EUS-guided drainage for complicated multilocular walled-off necrosis (with videos). Gastrointest. Endosc. 2014, 79, 531–535.Mukai S, Itoi T, Sofuni A, Itokawa F, Kurihara T, Tsuchiya T, Ishii K, Tsuji S, Ikeuchi N, Tanaka R. Novel single transluminal gateway transcystic multiple drainages after EUS-guided drainage for complicated multilocular walled-off necrosis (with videos). Gastrointest. Endosc. 2014, 79, 531–535.Jagielski M, Smoczyński M, Studniarek M, Adrych K. Endoscopic drainage combined with percutaneous drainage in treatment of walled-off pancreatic necrosis- a single center experience. Prz.Gastroenterol. 2018, 13, 137–142.Jagielski M, Smoczyński M, Studniarek M, Adrych K. Endoscopic drainage combined with percutaneous drainage in treatment of walled-off pancreatic necrosis- a single center experience. Prz.Gastroenterol. 2018, 13, 137–142.Ross A, Gluck M, Irani S. Combined endoscopic and percutaneous drainage of organized pancreatic necrosis. Gastrointest Endosc. 2010; 71: 79 – 84.Ross A, Gluck M, Irani S. Combined endoscopic and percutaneous drainage of organized pancreatic necrosis. Gastrointest Endosc. 2010; 71: 79 – 84.Brunschot S, Fockens P, Bakker OJ. Endoscopic transluminal necrosectomy in necrotizing pancreatitis: a systematic review. Surg Endosc. 2014; 28: 1425 – 1438.Brunschot S, Fockens P, Bakker OJ. Endoscopic transluminal necrosectomy in necrotizing pancreatitis: a systematic review. Surg Endosc. 2014; 28: 1425 – 1438.Siddiqui AA, Kowalski TE, Loren DE, Khalid A, Soomro A, Mazhar SM. Fully covered self-expanding metal stents versus lumen-apposing fully covered self-expanding metal stent versus plastic stents for endoscopic drainage of pancreatic walled-off necrosis: clinical outcomes and success. GastrointestEndosc. 2017; 85(4):758–65. https://doi.org/10.1016/j.gie.2016.08.014Siddiqui AA, Kowalski TE, Loren DE, Khalid A, Soomro A, Mazhar SM. Fully covered self-expanding metal stents versus lumen-apposing fully covered self-expanding metal stent versus plastic stents for endoscopic drainage of pancreatic walled-off necrosis: clinical outcomes and success. GastrointestEndosc. 2017; 85(4):758–65. https://doi.org/10.1016/j.gie.2016.08.014Abu Dayyeh BK, Mukewar S, Majumder S, et al. Large caliber metal stents versus plastic stents for the management of pancreatic walled-off necrosis. GastrointestEndosc. 2018; 87: 141–149.Abu Dayyeh BK, Mukewar S, Majumder S, et al. Large caliber metal stents versus plastic stents for the management of pancreatic walled-off necrosis. GastrointestEndosc. 2018; 87: 141–149.Shah RJ, Shah JN, Waxman I, Kowalski TE, Sanchez-Yague A, Nieto J. Safety and efficacy of endoscopic ultrasound-guided drainage of pancreatic fluid collections with lumen-apposing covered self-expanding metal stents.ClinGastroenterolHepatol. 2015; 13(4):747–52. https://doi.org/10.1016/j.cgh.2014.09.047Shah RJ, Shah JN, Waxman I, Kowalski TE, Sanchez-Yague A, Nieto J. Safety and efficacy of endoscopic ultrasound-guided drainage of pancreatic fluid collections with lumen-apposing covered self-expanding metal stents.ClinGastroenterolHepatol. 2015; 13(4):747–52. https://doi.org/10.1016/j.cgh.2014.09.047Sharaiha RZ, Tyberg A, Khashab MA. Endoscopic therapy with lumen-apposing metal stents is safe and effective for patients with pancreatic walled-off necrosis. Clin Gastroenterol Hepatol. 2016; 14:1797–1803.Sharaiha RZ, Tyberg A, Khashab MA. Endoscopic therapy with lumen-apposing metal stents is safe and effective for patients with pancreatic walled-off necrosis. Clin Gastroenterol Hepatol. 2016; 14:1797–1803.Cho IR, Chung MJ, Jo JH, Lee HS, Park JY, Bang S. A novel lumen-apposing metal stent with an antireflux valve for endoscopic ultrasound-guided drainage of pseudocysts and walled-off necrosis: A pilot study. PLoSONE. 2019; 14(9): e0221812. https://doi.org/10.1371/journal.pone.0221812Cho IR, Chung MJ, Jo JH, Lee HS, Park JY, Bang S. A novel lumen-apposing metal stent with an antireflux valve for endoscopic ultrasound-guided drainage of pseudocysts and walled-off necrosis: A pilot study. PLoSONE. 2019; 14(9): e0221812. https://doi.org/10.1371/journal.pone.0221812Bang JY, Navaneethan U, Hasan MK. Non-superiority of lumen-apposing metal stents over plastic stents for drainage of walled-off necrosis in a randomised trial. Gut. 2019; 68: 1200–9.Bang JY, Navaneethan U, Hasan MK. Non-superiority of lumen-apposing metal stents over plastic stents for drainage of walled-off necrosis in a randomised trial. Gut. 2019; 68: 1200–9.Patil R, Ona MA, Papafragkakis C, Anand S, Duddempudi S (2016) Endoscopic ultrasoundguided placement of AXIOS stent for drainage of pancreatic fluid collections. Ann Gastroenterol. 2009: 168–173.Patil R, Ona MA, Papafragkakis C, Anand S, Duddempudi S (2016) Endoscopic ultrasoundguided placement of AXIOS stent for drainage of pancreatic fluid collections. Ann Gastroenterol. 2009: 168–173.Bang J, Hawes R, Varadarajulu S. Lumen-apposing metal stent placement for drainageof pancreatic fluid collections: predictors of adverse events. Gut. 2020; 69: 1379–1381. doi:10.1136/gutjnl-2019-32053Bang J, Hawes R, Varadarajulu S. Lumen-apposing metal stent placement for drainageof pancreatic fluid collections: predictors of adverse events. Gut. 2020; 69: 1379–1381. doi:10.1136/gutjnl-2019-32053Bang JY, Hawes R, Bartolucci A. Efficacy of metal and plastic stents for transmural drainage of pancreatic fluid collections: a systematic review. DigEndosc. 2015; 27: 486 – 498.Bang JY, Hawes R, Bartolucci A. Efficacy of metal and plastic stents for transmural drainage of pancreatic fluid collections: a systematic review. DigEndosc. 2015; 27: 486 – 498.Mukai S, Itoi T, Baron TH. EUS-guided placement of plastic vs biflanged metal stent for therapy of walled-off necrosis: a retrospectivesingle center study. Endoscopy. 2015; 47: 47 – 55.Mukai S, Itoi T, Baron TH. EUS-guided placement of plastic vs biflanged metal stent for therapy of walled-off necrosis: a retrospectivesingle center study. Endoscopy. 2015; 47: 47 – 55.Bang JY, Hasan MK, Navaneethan U. Lumenapposing metal stents for drainage of pancreatic fluid collections: when and for whom? DigEndosc. 2017; 29:83–90.Bang JY, Hasan MK, Navaneethan U. Lumenapposing metal stents for drainage of pancreatic fluid collections: when and for whom? DigEndosc. 2017; 29:83–90.Rana S, Sharma R, Dhalaria L, Gupta R. Efficacy and safety of plastic versus lumen-apposing metal stents for transmural drainage of walled-off necrosis: a retrospective single-center study. Annals of Gastroenterology. 2020, 33, 426-432.Rana S, Sharma R, Dhalaria L, Gupta R. Efficacy and safety of plastic versus lumen-apposing metal stents for transmural drainage of walled-off necrosis: a retrospective single-center study. Annals of Gastroenterology. 2020, 33, 426-432.Rana S, Bashin D, Rao C. Consequences of long term indwelling transmural stents in patients with walled off pancreatic necrosis & disconnected pancreatic duct syndrome. Pancreatology. 2013; 13:486 – 490.Rana S, Bashin D, Rao C. Consequences of long term indwelling transmural stents in patients with walled off pancreatic necrosis & disconnected pancreatic duct syndrome. Pancreatology. 2013; 13:486 – 490.Varadarajulu S, Wilcox CM. Endoscopic placement of permanent indwelling transmural stents in disconnected pancreatic duct syndrome: Does benefit outweigh the risks? GastrointestEndosc. 2011;74: 1408 – 1412.Varadarajulu S, Wilcox CM. Endoscopic placement of permanent indwelling transmural stents in disconnected pancreatic duct syndrome: Does benefit outweigh the risks? GastrointestEndosc. 2011;74: 1408 – 1412.Bang JY, Hasan M, Navaneethan U. Lumen-apposing metal stents (LAMS) for pancreatic fluid collection (PFC) drainage: may not be business as usual. Gut. 2017; 66: 2054 – 2056.Bang JY, Hasan M, Navaneethan U. Lumen-apposing metal stents (LAMS) for pancreatic fluid collection (PFC) drainage: may not be business as usual. Gut. 2017; 66: 2054 – 2056.Siddiqui A, Naveed M, Basha J. International, multicenter retrospective trial comparing the efficy and safety of bi-flnged versus lumen-apposing metal stents for endoscopic drainage of walled-of pancreatic necrosis. Ann Gastroenterol. 2021; 34 (2): 273-281. https://doi.org/10.20524/aog.2021.0570Siddiqui A, Naveed M, Basha J. International, multicenter retrospective trial comparing the efficy and safety of bi-flnged versus lumen-apposing metal stents for endoscopic drainage of walled-of pancreatic necrosis. Ann Gastroenterol. 2021; 34 (2): 273-281. https://doi.org/10.20524/aog.2021.0570Bang JY, Arnoletti JP, Holt BA. An endoscopic transluminal approach, compared with minimally invasive surgery, reduces complications and costs for patients with necrotizing pancreatitis. Gastroenterology. 2019; 156:1027–1040Bang JY, Arnoletti JP, Holt BA. An endoscopic transluminal approach, compared with minimally invasive surgery, reduces complications and costs for patients with necrotizing pancreatitis. Gastroenterology. 2019; 156:1027–1040Seifert H, Biermer M, Schmitt W,Jurgensen C, Will U, Gerlach R. Transluminal endoscopic necrosectomy after acute pancreatitis: a multicentre study with long-term follow-up (the GEPARD Study).Gut. 2009; 58(9):1260–6. https://doi.org/10.1136/gut.2008.163733Seifert H, Biermer M, Schmitt W,Jurgensen C, Will U, Gerlach R. Transluminal endoscopic necrosectomy after acute pancreatitis: a multicentre study with long-term follow-up (the GEPARD Study).Gut. 2009; 58(9):1260–6. https://doi.org/10.1136/gut.2008.163733Saul A, Ramirez Luna MA, Chan C, Uscanga L, Valdovinos Andraca F, Hernandez Calleros J. EUS-guided drainage of pancreatic pseudocysts offers similar success and complications compared to surgical treatment but with a lower cost. Surgical endoscopy. 2016; 30(4):1459–65. https://doi.org/10.1007/s00464-015-4351-2Saul A, Ramirez Luna MA, Chan C, Uscanga L, Valdovinos Andraca F, Hernandez Calleros J. EUS-guided drainage of pancreatic pseudocysts offers similar success and complications compared to surgical treatment but with a lower cost. Surgical endoscopy. 2016; 30(4):1459–65. https://doi.org/10.1007/s00464-015-4351-2Papachristou GI, Takahashi N, Chahal P. Peroral endoscopic drainage/debridement of walled-off pancreatic necrosis. Ann Surg. 2007; 245: 943 – 951.Papachristou GI, Takahashi N, Chahal P. Peroral endoscopic drainage/debridement of walled-off pancreatic necrosis. Ann Surg. 2007; 245: 943 – 951.Bang JY, Wilcox CM, Trevino J. Factors impacting treatment outcomes in the endoscopic management of walled-off pancreatic necrosis. J Gastroenterol Hepatol. 2013; 28: 1725 – 1732.Bang JY, Wilcox CM, Trevino J. Factors impacting treatment outcomes in the endoscopic management of walled-off pancreatic necrosis. J Gastroenterol Hepatol. 2013; 28: 1725 – 1732.Puli SR, Graumlich JF, Pamulaparthy SR et al. Endoscopic transmural necrosectomy for walled-off pancreatic necrosis: a systematic review and meta-analysis. CanJGastroenterolHepatol. 2014; 28: 50 –53.Puli SR, Graumlich JF, Pamulaparthy SR et al. Endoscopic transmural necrosectomy for walled-off pancreatic necrosis: a systematic review and meta-analysis. CanJGastroenterolHepatol. 2014; 28: 50 –53.Rana SS, Bhasin DK, Sharma RK, Kathiresan J, Gupta R. Do the morphological features of walled off pancreatic necrosis on endoscopic ultrasound determine the outcome of endoscopic transmural drainage? Endosc Ultrasound. 2014; 3: 118-122 . DOI: 10.4103/2303-9027.13103927Rana SS, Bhasin DK, Sharma RK, Kathiresan J, Gupta R. Do the morphological features of walled off pancreatic necrosis on endoscopic ultrasound determine the outcome of endoscopic transmural drainage? Endosc Ultrasound. 2014; 3: 118-122 . DOI: 10.4103/2303-9027.13103927Vilmann A, Menachery J, Tang S, Srinivasan I, Vilmann P. EUS-guided management of pancreatic fluid collections.World JGastroenterol. 2015; 21(41): 11842-11853 DOI: 10.3748/wjg.v21.i41.11842Vilmann A, Menachery J, Tang S, Srinivasan I, Vilmann P. EUS-guided management of pancreatic fluid collections.World JGastroenterol. 2015; 21(41): 11842-11853 DOI: 10.3748/wjg.v21.i41.11842Maatman TK, McGuire SP, Flick KFM, Madison MK. Outcomes in endoscopic and operative transgastric pancreatic debridement. Annals of Surgery. 2021; 274: 3: 516-523 doi: 10.1097/SLA.0000000000004997Maatman TK, McGuire SP, Flick KFM, Madison MK. Outcomes in endoscopic and operative transgastric pancreatic debridement. Annals of Surgery. 2021; 274: 3: 516-523 doi: 10.1097/SLA.0000000000004997