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Upfront Endoscopic Necrosectomy Shows No Advantage Over Step-Up Approach

A systematic review finds no significant difference in outcomes between upfront endoscopic necrosectomy (UEN) and step-up endoscopic necrosectomy (SUEN) for walled-off pancreatic necrosis, influencing surgical decision-making.

  • Clinical success rates were similar: RR 1.04 (95% CI, 0.98-1.11).
  • Safety outcomes, including postprocedural bleeding and infection, also showed no significant differences.

Surgeons should consider individual patient factors when choosing between UEN and SUEN, as both approaches yield comparable results.

Review by Tazinkeng N, Elmustafa F (…) Igbinedion S et 6 al. in Gastrointest Endosc

Copyright © 2026 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

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