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©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 7, 2020; 26(41): 6431-6441
Published online Nov 7, 2020. doi: 10.3748/wjg.v26.i41.6431
Published online Nov 7, 2020. doi: 10.3748/wjg.v26.i41.6431
Endoscopic gastric fenestration of debriding pancreatic walled-off necrosis: A pilot study
Fang Liu, Department of Gastroenterology and Hepatology, Medical School of Chinese PLA, Beijing 100853, China
Fang Liu, Xiang-Dong Wang, Wen Li, Department of Gastroenterology and Hepatology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
Liang Wu, Department of International Center for Diagnosis and Treatment of Liver Disease, The Fifth Medical Center, Chinese PLA General Hospital, Beijing 100039, China
Jian-Guo Xiao, Department of Critical Care Medicine, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
Author contributions: Liu F and Wu L contributed equally to this manuscript; Li W and Liu F contributed to study conception and design, and the endoscopic operation; Liu F and Wu L wrote and edited the manuscript; Liu F, Wu L, Wang XD, and Xiao JG performed the endoscopic operation, data analysis and interpretation.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of the PLA General Hospital, No. s2019-298-02.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent.
Conflict-of-interest statement: All authors declare no conflicts-of-interest related to this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wen Li, MD, PhD, Chief Doctor, Department of Gastroenterology and Hepatology, The First Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing 100853, China. liwen2000@yahoo.com
Received: July 30, 2020
Peer-review started: July 23, 2020
First decision: August 8, 2020
Revised: August 22, 2020
Accepted: September 18, 2020
Article in press: September 18, 2020
Published online: November 7, 2020
Peer-review started: July 23, 2020
First decision: August 8, 2020
Revised: August 22, 2020
Accepted: September 18, 2020
Article in press: September 18, 2020
Published online: November 7, 2020
Core Tip
Core Tip: Endoscopic drainage of walled-off necrosis (WON) is still a challenge due to stent-associated problems. Endoscopic gastric fenestration may be an innovative alternative intervention for WON adherent to the gastric wall, and might outperform lumen-apposing metal stent drainage, with lower cost and no stent-related complications. The challenge is to select appropriate fenestration. We established some characteristics for suitable fenestration sites: Computed tomography: Intimate contact between the stomach and encapsulated WON without clear layers; endoscopy: Intense inflammation (edema, erosion or ulceration) of gastric mucosa; endoscopic ultrasound: Modest abutment (generally < 1 cm) of the stomach and WON without clear layers.