Immediate or On-Demand Endoscopic Necrosectomy for Necrotizing Pancreatitis: A Randomized Controlled Trial (WONDER-01) - PubMed
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- #Necrotizing Pancreatitis
- #Randomized Trial
- #Endoscopic Necrosectomy
- The study compared immediate direct endoscopic necrosectomy (DEN) versus a step-up approach after EUS-guided drainage for necrotizing pancreatitis.
- Immediate DEN showed a shorter time to clinical success (29 vs. 44 days) compared to the step-up approach.
- All patients in the immediate DEN group underwent DEN, while only 46% in the step-up group required it.
- Adverse event rates were similar between groups (24% vs. 22%).
- No significant differences were found in technical success or mortality rates.
- Immediate DEN reduced time to recovery without increasing complications but required more DEN procedures.