Endoscopic Necrosectomy of Walled-Off Necrosis following Severe Pancreatitis Using a Hot AxiosTM Stent - A Case Series

Kilian Weigand; Alexander Mehrl; Holger Goessmann; Martina Mueller; Arne Kandulski

doi:10.1159/000503991

Endoscopic Necrosectomy of Walled-Off Necrosis following Severe Pancreatitis Using a Hot AxiosTM Stent - A Case Series

Dig Dis. 2019 Nov 14:1-4. doi: 10.1159/000503991. Online ahead of print.

Authors

Kilian Weigand¹, Alexander Mehrl², Holger Goessmann³, Martina Mueller², Arne Kandulski²

Affiliations

¹ Department of Gastroenterology, University Hospital Regensburg, Regensburg, Germany, kilian.weigand@ukr.de.
² Department of Gastroenterology, University Hospital Regensburg, Regensburg, Germany.
³ Department of Radiology, University Hospital Regensburg, Regensburg, Germany.

PMID: 31726460
DOI: 10.1159/000503991

Abstract

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.

Keywords: Endoscopic treatment; Hot Axios; LAMS; Lumen-apposing metal stents; Necrosectomy; Pancreatitis; SEMS; Self-expandable metal stents.