https://www.selleckchem.com/peptide/box5.html Background and study aims The majority of patients with symptomatic sterile walled-off necrosis can be treated conservatively. Although endoscopic transluminal drainage is often performed in case of persistent symptoms, post-procedural iatrogenic infection may occur. The aim of this study was to evaluate the clinical outcome after endoscopic transluminal drainage of symptomatic sterile walled-off necrosis. Patients and methods Retrospective, multicenter, open-label case series of 56 patients with necrotizing pancreatitis who were drained endoscopically for symptomatic sterile walled-off necrosis between July 2001 and August 2018 at two tertiary referral hospitals. Primary endpoint was development of clinically relevant post-procedural iatrogenic infection, defined as need for endoscopic transluminal necrosectomy. Secondary endpoints included mortality, total number of interventions, hospital stay and resolution of symptoms at one-year follow-up. Results Endoscopic transluminal drainage of sterile walled-off necrosis was performed in 56 patients (57% male, median age 55 years), who presented with symptoms of abdominal pain (71%), gastric outlet obstruction (45%), jaundice (20%) and failure to thrive (27%). Forty-one patients (73%) developed clinically relevant post-procedural iatrogenic infection, resulting in a medium number of 3 endoscopic, radiological and/or surgical interventions (IQR 2 - 4). Mortality rate was 2%. Median total hospital stay was 12 days (IQR 6 - 17). Resolution of symptoms was reported in 40 of 46 patients (87%) for whom long-term follow-up was available (median follow-up of 13 months, IQR 6 - 29). Conclusions Endoscopic transluminal drainage of symptomatic sterile walled-off necrosis resulted in high clinical success. Nonetheless, in the majority of patients, additional reinterventions were needed due to clinically relevant post-procedural iatrogenic infection.Functional and anatomical connection be