Zeng Y, Zhang JW, Yang J. Endoscopic management of infected necrotizing pancreatitis: Advancing through standardization. World J Gastroenterol 2025; 31(20): 107451 [PMID: 40495946 DOI: 10.3748/wjg.v31.i20.107451]
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02542637
Submitted on:
June 15, 2025, 21:01
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Reader Comments:
The authors present a timely and comprehensive overview of endoscopic strategies for INP. Particularly commendable is the emphasis on procedural standardization, multidisciplinary decision-making, and the evolving role of lumen-apposing metal stents.
However, I would like to highlight one important clinical aspect that merits more attention: the influence of patient-specific immunonutritional status and comorbidities. Numerous studies, including work by Zerem et al., have shown that sarcopenia, hypoalbuminemia, and diabetes mellitus are significant predictors of poor clinical outcomes and secondary infections, even after technically successful drainage procedures. Acknowledging and integrating these patient-level risk factors into procedural decision-making could enhance the individualization of care and improve long-term outcomes.
Additionally, while the authors discuss timing and technique in detail, post-procedural follow-up protocols are only briefly addressed. Standardized imaging and biomarker-based follow-up strategies could reduce inter-center variability and help detect complications early.
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First, thank you very much for your professional comments on the article published in World Journal of Gastroenterology.
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Author's Reply:
Replied on June 17, 2025, 06:43
Thank you for your insightful comments on our manuscript. We greatly appreciate your attention to the importance of patient-specific immunonutritional status and comorbidities in the management of INP. We fully agree that these factors are crucial in real-world perioperative care for INP patients and significantly influence clinical outcomes. We hope to delve deeper into the impact of immunonutritional status and comorbidities, as well as post-procedural follow-up, in our future work.