In this article, an attempt was made to clarify the role of percutaneous endoscopic necrosectomy (PEN) in the interventional treatment of pancreatic necrosis. A comprehensive review of the current literature was performed to identify publications on the role of PEN in patients with consequences of acute necrotizng pancreatitis. The aim of the study was to review the literature on minimal invasive necrosectomy, with emphasis on PEN using esophageal self-expanding metal stents (SEMS). The described results come from 15 studies after a review of the current literature. The study group comprised 52 patients (36 men and 16 women; mean age, 50.87 (13–75) years) with walled-off pancreatic necrosis, in whom PEN using a self-expandable esophageal stent had been performed. PEN was successfully completed in all 52 patients (100%). PEN complications were observed in 18/52 (34.62%) patients. Clinical success was achieved in 42/52 (80.77%) patients, with follow-up continuing for an average of 136 (14–557) days. In conclusion, the PEN technique is potentially effective, with an acceptable rate of complications and may be implemented with good clinical results in patients with pancreatic necrosis.

Background: Minimally invasive approaches for managing complications of acute necrotizing pancreatitis have advanced significantly in recent decades. When extensive walled-off pancreatic or peripancreatic necrosis is present, a single transluminal access may be insufficient. This study aimed to prospectively evaluate the effectiveness and safety of a novel percutaneous endoscopic necrosectomy technique used as an adjunct to transmural drainage in patients with symptomatic walled-off necrosis. Methods: A total of 513 consecutive patients with symptomatic walled-off pancreatic or peripancreatic necrosis treated between 2018 and 2025 at a single tertiary center in Poland were included. All patients underwent minimally invasive endoscopic management. Among them, a subgroup required additional percutaneous drainage. The innovative technique involved creating retroperitoneal percutaneous access to the necrotic cavity, enlarging the tract, and placing a self-expanding metal stent to allow passage of the endoscope for percutaneous endoscopic necrosectomy. Results: Additional percutaneous drainage was necessary in 39/513 patients (7.6%). Of these, 9/39 (23.1%) patients (2 women, 7 men; mean age 46.7 years) underwent percuaneous endoscopic necrosectomy. The mean size of the necrotic collection was 25.96 cm. Active percutaneous drainage during ongoing transmural endotherapy lasted a median of 15 days. Patients underwent an average of 3.12 necrosectomy sessions. Treatment-related complications occurred in 2/9 patients (22.22%). Clinical and long-term success were each achieved in 8/9 patients (88.89%). Conclusions: Percutaneous endoscopic necrosectomy is a promising minimally invasive therapeutic option for extensive walled-off pancreatic and peripancreatic necrosis, particularly when necrosis extends into the pelvic region. However, clinical evidence remains limited and further studies are needed.

Benign cystic and tumor lesions of the jaw bones represent relatively frequent pathological conditions encountered in oral and maxillofacial surgery. Although these lesions are often asymptomatic and slow-growing, they may lead to progressive weakening of bone structure. In individuals exposed to repetitive mechanical forces, such as athletes participating in contact sports, the presence of such lesions may significantly increase the risk of pathological fractures of the facial skeleton. The aim of the present study was to present a clinical case series of a benign jaw bone lesion treated surgically using a biphasic calcium sulfate biomaterial and to discuss the potential relevance of such lesions in athletes exposed to craniofacial trauma. The treatment involved surgical enucleation of the lesion followed by reconstruction of the bone defect using a biphasic calcium sulfate biomaterial (Bond Apatite®). Postoperative healing was uneventful, and radiological follow-up demonstrated progressive bone regeneration and gradual replacement of the biomaterial with newly formed bone tissue. The presented case series highlights the importance of early diagnosis and appropriate surgical management of jaw bone lesions, particularly in athletes exposed to craniofacial trauma. Reconstruction of bone defects using modern biomaterials may contribute to restoration of bone integrity and reduction of pathological fracture risk during sports activity.

Gallbladder stones are one of the most common gastrointestinal diseases requiring surgical treatment. Currently, the standard in the treatment of symptomatic, including complicated gallbladder stones, is laparoscopic cholecystectomy. This paper presents a detailed description of gallbladder stones, starting with epidemiology, pathophysiology, clinical presentation and treatment.

Introduction: Endotherapy is an established minimally invasive treatment for pancreatic necrosis. Aim: This study aims to evaluate the efficacy and safety of direct endoscopic necrosectomy (DEN) performed during transmural drainage in patients with symptomatic walled-off pancreatic necrosis (WOPN). Materials and Methods: A retrospective analysis was conducted of 512 patients with symptomatic WOPN treated endoscopically between 2018 and 2025 at the Department of General, Gastroenterological and Oncological Surgery, Collegium Medicum, Nicolaus Copernicus University in Toruń. In patients qualified for endoscopic necrosectomy, an endoscope was introduced into the necrotic cavity through a previously created transmural (transgastric or transduodenal) fistula, and necrotic tissue was removed using various endoscopic tools. Results: All 512 patients underwent transmural endoscopic drainage. Of these, 226/512 (44.14%) patients (61 women, 165 men; mean age 51.8 [20–78] years) were qualified for endoscopic necrosectomy. The mean size of the necrotic collection was 22.9 (10.6–36.6) cm. A transgastric approach was used in 219/226 (96.9%) patients, and a transduodenal approach in 7/226 (3.1%). Active drainage was maintained for a mean of 16 (7–82) days. The mean number of endoscopic procedures was 4.84 (1–24). Complications occurred in 24/226 (10.61%) patients. Mortality was 5.75% (13/226). Clinical success was achieved in 203/226 (89.82%) patients and long-term success in 197/226 (87.17%). Conclusions: Direct endoscopic necrosectomy performed during transmural drainage achieved high clinical and long-term success with acceptable morbidity in patients with symptomatic WOPN.