Encapsulation levels rather than elapsed time after the onset of acute pancreatitis are related to clinical outcomes of pancreatic walled-off necrosis

There is no consensus regarding the optimal timing of endoscopic ultrasound (EUS)-guided interventions for walled-off necrosis (WON) secondary to acute pancreatitis. Currently, intervention timing is primarily determined by the duration after the onset of acute pancreatitis, which potentially serves as a surrogate for fluid collection maturation. We hypothesized that the encapsulation status may be more strongly correlated with clinical outcomes.Between January 2010 and November 2020, 222 patients who underwent EUS-guided WON treatment at 11 centers of the WONDERFUL consortium were included. The patients were divided into two groups based on their encapsulation status at drainage (partial/no vs. complete). The clinical outcomes were compared between groups.Technical success rates were similar between the groups. Complete encapsulation was associated with a higher clinical success rate (88.1% vs. 52.2%; <i>P</i><0.001). When patients were classified by both time elapsed and encapsulation status, the encapsulation status was more strongly associated with clinical success. Complete encapsulation was associated with a lower overall adverse event rate (22.7% vs. 39.1%; <i>P</i>=0.04). Overall mortality was significantly higher in the partial/no encapsulation group (34.8% vs. 3.4%; <i>P</i> <0.001). In multivariable analysis, the encapsulation status and diameter of the WON were identified as significant factors associated with clinical success.In patients undergoing EUS-guided WON treatment, the encapsulation status, rather than the time elapsed since disease onset, appeared to be more strongly associated with positive clinical outcomes.

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Journal
Endoscopy
Published
2025-07-12
DOI
https://doi.org/10.1055/a-2654-4317
Citations
3
Primary Topic
Pancreatitis Pathology and Treatment
Type
article
Field-Weighted Citation Impact
6.02

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article

Encapsulation levels rather than elapsed time after the onset of acute pancreatitis are related to clinical outcomes of pancreatic walled-off necrosis

Akinori Maruta, Kensaku Yoshida, Shogo Ota, Saburo Matsubara et al.
3 citations
Endoscopy
Pancreatitis Pathology and Treatment
6.02
article

Encapsulation levels rather than elapsed time after the onset of acute pancreatitis are related to clinical outcomes of pancreatic walled-off necrosis

Akinori Maruta, Kensaku Yoshida, Shogo Ota, Saburo Matsubara, Hideyuki Shiomi, Shunsuke Omoto, Nobuhiko Hayashi, Takuji Iwashita, Ichiro Yasuda, Toshio Fujisawa, Tomotaka Saito, Sho Takahashi, Yuhei Iwasa, Atsuhiro Masuda, Yousuke Nakai, Tsuyoshi Hamada, Wataru Gonoi, Kentaro Suda, Masahiro Tsujimae, Tsuyoshi Mukai, Mamoru Takenaka, Keisuke Iwata, Shinya Uemura
article en
3 citations

Abstract

There is no consensus regarding the optimal timing of endoscopic ultrasound (EUS)-guided interventions for walled-off necrosis (WON) secondary to acute pancreatitis. Currently, intervention timing is primarily determined by the duration after the onset of acute pancreatitis, which potentially serves as a surrogate for fluid collection maturation. We hypothesized that the encapsulation status may be more strongly correlated with clinical outcomes.Between January 2010 and November 2020, 222 patients who underwent EUS-guided WON treatment at 11 centers of the WONDERFUL consortium were included. The patients were divided into two groups based on their encapsulation status at drainage (partial/no vs. complete). The clinical outcomes were compared between groups.Technical success rates were similar between the groups. Complete encapsulation was associated with a higher clinical success rate (88.1% vs. 52.2%; <i>P</i><0.001). When patients were classified by both time elapsed and encapsulation status, the encapsulation status was more strongly associated with clinical success. Complete encapsulation was associated with a lower overall adverse event rate (22.7% vs. 39.1%; <i>P</i>=0.04). Overall mortality was significantly higher in the partial/no encapsulation group (34.8% vs. 3.4%; <i>P</i> <0.001). In multivariable analysis, the encapsulation status and diameter of the WON were identified as significant factors associated with clinical success.In patients undergoing EUS-guided WON treatment, the encapsulation status, rather than the time elapsed since disease onset, appeared to be more strongly associated with positive clinical outcomes.

EndoscopyVol. 57(12)
Hyogo Medical University (JP), Kanazawa Medical University (JP), Juntendo University (JP), Kindai University Hospital (JP), Gifu Municipal Hospital (JP), Gifu University Hospital (JP), University of Tokyo Hospital (JP), Kanazawa Medical University Hospital (JP), Gifu Prefectural General Medical Center (JP), Tokyo Women's Medical University (JP), Social Insurance Saitama Chuo Hospital (JP), Japanese Foundation For Cancer Research (JP), University of Toyama (JP), Kobe University (JP), The University of Tokyo (JP), Hyogo University (JP), Saitama Medical University (JP), Kindai University (JP)
Japanese Foundation for Research and Promotion of Endoscopy
Good health and well-being
Openalex Percentile: Top 4%
Pancreatitis Pathology and Treatment
6.02
DOISourceOpenAlex
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