Walled-off Pancreatic Necrosis: Multidisciplinary Perspective

Abstract Walled-off pancreatic necrosis is a potential sequela of necrotizing pancreatitis. When drainage is indicated, such as in the setting of local complications (biliary or bowel obstruction), superinfection, or the collection causing abdominal pain, endoscopic, percutaneous, and surgical approaches are possible. Endoscopic drainage with or without placement of a luminal apposing metal stent and possible direct endoscopic necrosectomy is the preferred approach for drainage given good outcomes and patient comfort. In some cases, due to location and/or lack of a mature wall, endoscopic drainage is not possible or may be ineffective. In such cases, percutaneous and/or surgical drainage may be necessary.