Abstract
Pancreatic pseudocyst (PPC)/walled-off necrosis (WON) after severe acute pancreatitis is a typical tardive complication, and, as for the case of a symptomatic WON or infected WON, drainage is required. EUS-guided drainage through the gastrointestinal tract has been widespread and good treatment outcomes for PPC were reported. However, WON contains necrotic debris, and therefore often requires more aggressive therapy such as endoscopic necrosectomy. Drainage using a large bored dedicated metal stent, additional endoscopic drainage technique, and hybrid approach through percutaneous drainage were reported. Owing to the remarkable progress of endoscopic therapy, almost all WON has become treatable by endoscopic therapy alone. However, a wide visual field would be needed if surgery is required for the treatment of WON without the need of endoscopic therapy.
