Open AccessEndoscopic Necrosectomy of Walled-Off Necrosis following Severe Pancreatitis Using a Hot Axios<sup>TM</sup> Stent – A Case Series
Author(s) -
Kilian Weigand,
Alexander Mehrl,
Holger Goessmann,
Michael Mueller,
Arne Kandulski
Publication year - 2019
Publication title -
digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.879
H-Index - 66
eISSN - 1421-9875
pISSN - 0257-2753
DOI - 10.1159/000503991
Subject(s) - medicine , stent , surgery , necrotizing pancreatitis , pancreatitis , complication , necrosis , endoscopic treatment , lumen (anatomy) , endoscopy
Background: Walled-off necrosis is a common complication of severe pancreatitis. Guidelines recommend endoscopic transgastric necrosectomy as therapy of choice. Different endoscopic approaches are possible. Methods: We retrospectively analyzed our series of 9 patients where necrosectomy was performed after application of a lumen-apposing metal stent (LAMS) delivered using a Hot AxiosTM Stent device. Results: In all 9 cases, the walled-off necrosis resolved completely. Necrosectomy was performed through the LAMS (mean: 5.7 times). Endoscopic necrosectomy was repeated every 3rd–7th day using 10- or 15-mm snares. There were no major complications. Especially, no early or delayed bleeding was seen. Conclusion: The Hot AxiosTM Stent device is a safe method for necrosectomy of walled-off necrosis. It enables puncture, drainage, and LAMS insertion in a single delivery, followed by several courses of necrosectomy if needed without stent exchange.