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RWON Study: The Real-World Walled-off Necrosis Study
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Ankush Pawar, Ujjwal Sonika, Manish Kumar, Sundeep Saluja, Siddharth Srivastava
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Clin Endosc 2021;54(6):909-915. Published online February 23, 2021
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DOI: https://doi.org/10.5946/ce.2020.175
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 Abstract
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- Background
/Aims: The management of walled-off necrosis (WON) has undergone a paradigm shift from surgical to nonsurgical modalities. 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 used were medical management alone, percutaneous catheter drainage (PCD) or endoscopic drainage (ED), or a combination of PCD and ED. 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 success and 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 endoscopic group than in the PCD group.
Conclusions
ED of WON is better than PCD and is associated with lower mortality, fewer complications, and shorter hospitalization.
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Citations
Citations to this article as recorded by  - Endoscopic ultrasound drainage of pancreatic fluid collections: do we know enough about the best approach?
Andrada Seicean, Cristina Pojoga, Voicu Rednic, Claudia Hagiu, Radu Seicean
Therapeutic Advances in Gastroenterology.2023;[Epub] CrossRef - Treatment of Walled-off Necrosis – Outcomes are Best When Endoscopy and Percutaneous Interventions are Complimentary, Not Exclusive
Ji Young Bang, Shyam Varadarajulu
Clinical Endoscopy.2021; 54(6): 785. CrossRef
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