Endoscopic transluminal drainage and necrosectomy for infected necrotizing pancreatitis: Progress and challenges

Abstract

Infected necrotizing pancreatitis (INP) represents a severe condition in patients with acute pancreatitis. Invasive interventions are recommended in symptomatic INP. Growing evidence has suggested interventional strategies of INP evolving from traditional surgery to minimally invasive step-up endoscopic procedures. However, there is still no standardized protocol for endoscopic interventions. Recently, various studies have been published about the endoscopic management of INP. This article reviews published articles and guidelines to present the progress and challenges of endoscopic transluminal drainage and necrosectomy in INP.

Keywords: Endoscopic; Drainage; Necrosectomy; Infected necrotizing pancreatitis; Progress; Challenge

Core Tip: Infected necrotizing pancreatitis (INP) is a severe condition in patients with acute pancreatitis. Endoscopic transluminal drainage and necrosectomy, especially endoscopic ultrasound-guided treatments, have become the mainstream minimally-invasive treatment for symptomatic INP. Growing evidence has proven progress in endoscopic transluminal interventions, while challenges and unsolved problems still need further investigation. Endoscopic transluminal interventions are neither omnipotent nor perfect. The predominant role of endoscopic treatment will be further developed with the advancements, standardization, and popularization of endoscopic techniques and devices in the near future.