{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T20:10:09Z","timestamp":1748635809078,"version":"3.41.0"},"reference-count":0,"publisher":"Romanian Society of Gastroenterology and Hepatology","issue":"1","license":[{"start":{"date-parts":[[2024,3,29]],"date-time":"2024-03-29T00:00:00Z","timestamp":1711670400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JGLD"],"abstract":"<jats:p>Background and Aims: Walled-off necrosis (WON) is a serious complication of severe pancreatitis, patients with necrotizing pancreatitis having an increased risk of developing diabetes mellitus (DM). The aim of this study was to assess the frequency of new-onset diabetes (NOD) in patients with symptomatic WON after endoscopic ultrasound (EUS)-guided drainage with lumen-apposing metal stents (LAMS).\r\nMethods: We retrospectively analyzed a prospectively collected database of patients with symptomatic WON treated by EUS-guided drainage with LAMS in a tertiary referral center. The patients were followed-up for at least 12 months after stent removal. These patients were compared with age- and sex-matched asymptomatic WON controls without interventional treatment and healthy controls to assess the one-year occurrence of DM. Diabetes was defined according to the American Diabetes Association criteria.\r\nResults: Of the 50 patients with symptomatic WON included in the study (male\/female ratio, 33:17; median age, 60 years), 13 patients (26%) had pre-existing DM and were excluded. Ten of the remaining 37 patients (27%) without prior DM developed NOD within one year after stent removal, this frequency being higher than in asymptomatic WON controls (18.9%, p=0.581) and healthy controls (2%, p = 0.002). In the symptomatic WON group, NOD patients compared to non-DM patients were older (63.5 vs. 56 years old, p=0.042), had more frequent necrosis &gt; 50% of the pancreatic parenchyma (p=0.002) and had a body-tail location of WON (p&lt;0.001). On multivariate analysis, the number of direct endoscopic necrosectomy (DEN) sessions was the only significant factor for NOD occurrence (OR=7.05, p=0.010). NOD patients had poor glycemic control and required more DEN sessions to achieve WON resolution than patients with prior DM (p=0.017).\r\nConclusions: In patients with symptomatic WON treated by EUS-guided drainage, DM occurred in 27% of previously non-diabetic patients within one year of follow-up. Patients with extensive pancreatic necrosis were more likely to develop NOD, a high number of DEN sessions being a significant risk factor for NOD occurrence.<\/jats:p>","DOI":"10.15403\/jgld-5142","type":"journal-article","created":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T23:26:14Z","timestamp":1708557974000},"page":"65-73","source":"Crossref","is-referenced-by-count":0,"title":["New-onset Diabetes Mellitus after EUS-guided Drainage with LAMS: A Pilot Study"],"prefix":"10.15403","volume":"33","author":[{"given":"Teodora","family":"Man","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice","family":"Spulber Sfara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lidia","family":"Neamti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandru","family":"Istrate","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica Mihaela","family":"Marta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Pojoga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Radu","family":"Seicean","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Voicu","family":"Rednic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrada","family":"Seicean","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"6121","published-online":{"date-parts":[[2024,3,29]]},"container-title":["Journal of Gastrointestinal and Liver Diseases"],"original-title":[],"link":[{"URL":"https:\/\/www.jgld.ro\/jgld\/index.php\/jgld\/article\/download\/5142\/2014","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.jgld.ro\/jgld\/index.php\/jgld\/article\/download\/5142\/2013","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T19:51:08Z","timestamp":1748634668000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jgld.ro\/jgld\/index.php\/jgld\/article\/view\/5142"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,29]]},"references-count":0,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,3,30]]}},"URL":"https:\/\/doi.org\/10.15403\/jgld-5142","relation":{},"ISSN":["1842-1121","1841-8724"],"issn-type":[{"type":"electronic","value":"1842-1121"},{"type":"print","value":"1841-8724"}],"subject":[],"published":{"date-parts":[[2024,3,29]]}}}