Immediate Versus On-Demand Direct Endoscopic Necrosectomy for Necrotizing Pancreatitis: A Systematic Review and Meta-Analysis.

United European Gastroenterol JSep 1, 2026
Clinical ResearchGastroenterologyOpen access

Rui Wang, Qingzhou Kong, Ping Hu et al.

✦ AI-curated · Sources linked

In 30 seconds

This systematic review and meta-analysis evaluated the efficacy and safety of immediate versus on-demand direct endoscopic necrosectomy (DEN) for necrotizing pancreatitis in 616 patients across seven studies. The analysis found no significant advantage of immediate DEN in clinical success (OR: 1.92, 95% CI 1.01-3.63), suggesting that timing may not impact overall outcomes.

Key findings

  • Immediate DEN showed no significant advantage in clinical success (OR: 1.92, 95% CI 1.01-3.63).
  • Technical success rates were similar between immediate and on-demand DEN (OR: 1.62, 95% CI: 0.43-6.09).
  • Procedure-related adverse events were comparable between both groups (OR: 0.81, 95% CI: 0.51-1.28).
  • Immediate DEN reduced stent migration risk (OR: 0.31, 95% CI: 0.11-0.92), though significance was lost in RCT-only analysis.

Why it matters

Understanding the timing of direct endoscopic necrosectomy is crucial for optimizing treatment strategies in necrotizing pancreatitis. This study suggests that immediate intervention may not confer overall benefits, prompting further investigation into specific patient subgroups.

Source

PubMed · PMID 42675663Free full text on PubMed Central

Published in United European Gastroenterol J. This summary was written by xxcode from the publication's abstract and metadata. It is not peer reviewed and is not a substitute for the original article. For clinical decisions, review the original publication.

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