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Walled off necrosis

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https://www.readbyqxmd.com/read/29774088/endoscopic-ultrasound-guided-drainage-of-pancreatic-walled-off-necrosis-using-self-expanding-metal-stents-without-fluoroscopy
#1
Barbara Braden, Andreas Koutsoumpas, Michael A Silva, Zahir Soonawalla, Christoph F Dietrich
AIM: To investigate whether endoscopic ultrasound (EUS)-guided insertion of fully covered self-expandable metal stents in walled-off pancreatic necrosis (WOPN) is feasible without fluoroscopy. METHODS: Patients with symptomatic pancreatic WOPN undergoing EUS-guided transmural drainage using self-expandable and fully covered self expanding metal stents (FCSEMS) were included. The EUS visibility of each step involved in the transmural stent insertion was assessed by the operators as "visible" or "not visible": (1) Access to the cyst by needle or cystotome; (2) insertion of a guide wire; (3) introducing of the diathermy and delivery system; (4) opening of the distal flange; and (5) slow withdrawal of the delivery system until contact of distal flange to cavity wall...
May 16, 2018: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29773762/endoscopic-treatment-of-extensive-walled-off-pancreatic-necrosis-with-the-use-of-single-transluminal-gateway-transcystic-multiple-drainage-sgtmd
#2
Mateusz Jagielski, Marian Smoczyński, Krystian Adrych
The paper presents a description of the course of severe acute necrotizing pancreatitis as well as endoscopic treatment of an extensive infected walled-off pancreatic necrosis (WOPN), being the consequence of acute pancreatitis. The basic strategy of interventional treatment was to extend access to necrotic areas with use of single transluminal gateway transcystic multiple drainage (SGTMD). Endoscopic transmural access (transgastric) was applied. Endoscopic necrosectomy under fluoroscopic guidance was repeated nine times during active transluminal drainage...
April 30, 2018: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/29770780/placement-of-lumen-apposing-metal-stents-to-drain-pseudocysts-and-walled-off-pancreatic-necrosis-can-be-safely-performed-on-an-outpatient-basis-a-multicenter-study
#3
Douglas G Adler, Janak Shah, Jose Nieto, Kenneth Binmoeller, Yasser Bhat, Linda Jo Taylor, Ali A Siddiqui
Backgrounds and Objectives: No study on the use of lumen-apposing fully covered self-expanding metal stent (LAMS) to drain pancreatic fluid collections (PFCs) has evaluated outcomes of patients in the outpatient setting. The objective of this multicenter study was to evaluate the clinical outcomes, success rate, and adverse events of the LAMS for endoscopic ultrasound (EUS)-guided transmural drainage of patients with symptomatic PFCs on an inpatient versus an outpatient basis. Methods: This was a multicenter, retrospective study conducted at 4 tertiary care centers...
May 17, 2018: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/29752684/natural-history-of-gas-configurations-and-encapsulation-in-necrotic-collections-during-necrotizing-pancreatitis
#4
Janneke van Grinsven, Sandra van Brunschot, Mark C van Baal, Marc G Besselink, Paul Fockens, Harry van Goor, Hjalmar C van Santvoort, Thomas L Bollen
BACKGROUND: Decision-making on invasive intervention in patients with clinical signs of infected necrotizing pancreatitis is often related to the presence of gas configurations and the degree of encapsulation in necrotic collections on imaging. Data on the natural history of gas configurations and encapsulation in necrotizing pancreatitis are, however, lacking. METHODS: A post hoc analysis was performed of a previously described prospective cohort in 21 Dutch hospitals (2004-2008)...
May 11, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29739185/is-percutaneous-endoscopic-necrosectomy-really-safe-and-effective-for-symptomatic-laterally-placed-walled-off-necrosis
#5
Se Woo Park
No abstract text is available yet for this article.
May 9, 2018: Clinical Endoscopy
https://www.readbyqxmd.com/read/29736167/mechanisms-and-management-of-acute-pancreatitis
#6
REVIEW
Ari Garber, Catherine Frakes, Zubin Arora, Prabhleen Chahal
Acute pancreatitis represents a disorder characterized by acute necroinflammatory changes of the pancreas and is histologically characterized by acinar cell destruction. Diagnosed clinically with the Revised Atlanta Criteria, and with alcohol and cholelithiasis/choledocholithiasis as the two most prominent antecedents, acute pancreatitis ranks first amongst gastrointestinal diagnoses requiring admission and 21st amongst all diagnoses requiring hospitalization with estimated costs approximating 2.6 billion dollars annually...
2018: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/29685110/wirsung-atraumatic-rupture-in-patient-with-pancreatic-pseudocysts-a-case-presentation
#7
Martino Gerosa, Marco Chiarelli, Angelo Guttadauro, Matilde De Simone, Fulvio Tagliabue, Melchiorre Costa, Sabina Terragni, Ugo Cioffi
BACKGROUND: Pancreatic duct disruption is a challenging condition leading to pancreatic juice leakage and consequently to pancreatic fluid collections. The manifestations of pancreatic main duct leak include pseudocysts, walled-off necrosis, pancreatic fistulas, ascites, pleural and pericardial effusions. Pseudocyst formation is the most frequent outcome of a pancreatic duct leak. CASE PRESENTATION: We describe a case of a 64-year old man with large multiple pancreatic cysts discovered for progressive jaundice and significant weight loss in the absence of a previous episode of acute pancreatitis...
April 23, 2018: BMC Gastroenterology
https://www.readbyqxmd.com/read/29675786/the-microbiology-of-infected-pancreatic-necrosis-in-the-era-of-minimally-invasive-therapy
#8
Nadav Sahar, Richard A Kozarek, Zaheer S Kanji, Shingo Chihara, S Ian Gan, Shayan Irani, Michael Larsen, Andrew S Ross, Michael Gluck
We aimed to determine the microbiology of infected walled-off pancreatic necrosis (WON) in an era of minimally invasive treatment, since current knowledge is based on surgical specimens performed over two decades ago. We retrospectively analyzed a prospectively maintained database of patients who were treated for symptomatic WON using combined endoscopic and percutaneous drainage between 2008 and 2017. Aspirates from WON at initial treatment were evaluated. One hundred eighty-two patients were included with a mean age of 56 of whom 67% were male...
April 19, 2018: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29663019/-retrieval-of-a-migrated-plastic-stent-in-a-51-year-old-man
#9
A Poszler, P Klare, A Weber, M Abdelhafez, K Holzapfel, R M Schmid, S von Delius
BACKGROUND: Endosonographically guided transgastric drainage is the first-line interventional therapy of walled-off necrosis and symptomatic pancreatic pseudocysts in necrotizing pancreatitis. Plastic stents or lumen apposing metal stents are commonly used. A possible complication of endoscopic therapy is stent migration. CASE REPORT: We report upon a 51-year-old man who presented with acute necrotizing pancreatitis. Transgastric necrosectomy was performed and 5 transmural double-pigtail stents (DPS) were left in situ to drain the residual retroperitoneal cavity...
April 16, 2018: Der Internist
https://www.readbyqxmd.com/read/29628208/complex-gastroschisis-clinical-spectrum-and-neonatal-outcomes-at-a-referral-center
#10
Pablo Laje, Maria V Fraga, William H Peranteau, Holly L Hedrick, Nahla Khalek, Juliana S Gebb, Julie S Moldenhauer, Mark P Johnson, Alan W Flake, N Scott Adzick
AIM OF THE STUDY: To evaluate the outcomes of neonates with complex gastroschisis (GC), and correlate outcomes with each type of complication. METHODS: Retrospective review of patients with complex GC owing to prenatal and/or postnatal abdominal complications; 2008-2016. Primary outcomes: time to discontinue parenteral nutrition (off-PN), length of stay (LOS) and neonatal survival. MAIN RESULTS: We treated 58 patients with complex gastroschisis owing to abdominal complications, which were: intestinal necrosis at birth (n=9), intestinal atresia (n=16), medical necrotizing enterocolitis (NEC) (n=15), surgical NEC (n=1), in utero volvulus (n=1), vanishing gastroschisis (n=2), severe intestinal dysmotility (n=1), delayed abdominal closure (n=3), abdominal compartment syndrome (n=2) and hiatal hernia/severe gastroesophageal reflux disease (GERD; n=11)...
March 14, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29619526/imaging-of-endoscopic-cystogastrostomy-in-pancreatic-walled-off-necrosis-what-the-radiologist-needs-to-know
#11
REVIEW
Anthony Abou Karam, Arya Bagherpour, Jesus Calleros, Shaked Laks
Acute pancreatitis is a frequent entity encountered by radiologists. In 2012, the Atlanta criteria were revised to help radiologists use a common nomenclature when describing acute pancreatitis and its complications. One delayed complication of acute necrotizing pancreatitis in walled-off necrosis, a collection seen at least 4 weeks after an episode of acute pancreatic necrosis and/or acute peripancreatic necrosis. Multiple treatments have been adapted in the setting of walled-off necrosis, including endoscopic cystogastrostomy...
April 4, 2018: Abdominal Radiology
https://www.readbyqxmd.com/read/29614262/cost-effectiveness-analysis-comparing-lumen-apposing-metal-stents-with-plastic-stents-in-the-management-of-pancreatic-walled-off-necrosis
#12
Yen-I Chen, Alan N Barkun, Viviane Adam, Ge Bai, Vikesh K Singh, Majidah Bukhari, Olaya Brewer Gutierrez, B Joseph Elmunzer, Robert Moran, Lea Fayad, Mohamad El Zein, Vivek Kumbhari, Alessandro Repici, Mouen A Khashab
BACKGROUND AND AIMS: EUS-guided transmural drainage is effective in the management of pancreatic walled-off necrosis (WON). A lumen-apposing metal stent (LAMS) has recently been developed specifically for the drainage of pancreatic fluid collections showing promising results. However, no cost-effectiveness data have been published in comparison to endoscopic drainage with traditional plastic stents (PSs). The aim is to compare the cost-effectiveness of LAMSs to PSs in the management of WON...
March 31, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29607399/endoscopic-versus-percutaneous-management-for-symptomatic-pancreatic-fluid-collections-a-systematic-review-and-meta-analysis
#13
Muhammad Ali Khan, Tariq Hammad, Zubair Khan, Wade Lee, Monica Gaidhane, Amy Tyberg, Michel Kahaleh
Background:  Symptomatic pancreatic fluid collections (PFCs) are managed by surgical, percutaneous, or endoscopic drainage. Due to morbidity associated with surgical drainage, percutaneous and/or endoscopic options have increasingly been used as initial management. Aims:  We conducted a systematic review and meta-analysis comparing the efficacy and safety of endoscopic versus percutaneous drainage for management of PFCs. Methods:  We searched several databases from inception through 31 August 2017 to identify comparative studies using endoscopic or percutaneous drainage for PFCs...
April 2018: Endoscopy International Open
https://www.readbyqxmd.com/read/29601903/endoscopic-drainage-of-pancreatic-fluid-collections
#14
REVIEW
B Joseph Elmunzer
Endoscopy has emerged as a mainstay in the management of pancreatic fluid collections (PFCs), representing an important advance in clinical medicine that has significantly improved the risk-benefit ratio of treating this complex patient population. While endoscopic pseudocyst drainage has generally supplanted surgical and percutaneous approaches, the optimal strategy for walled-off necrosis remains variable and multi-disciplinary despite an emerging trend from randomized trials favoring endoscopy. Although several issues pertaining to endoscopic drainage appear to have been settled - such as the use of endoscopic ultrasound - other pressing questions - including the optimal prosthesis and debridement strategy - remain unanswered, and rigorous investigation is needed...
March 27, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29541568/triple-pancreatic-walled-off-fluid-collections-treated-simultaneously-with-endoscopic-transmural-drainage
#15
Sameen Khalid, Aamer Abbass, Eric Nellis, Shashin Shah, Hiral Shah
Pancreatic pseudocysts and walled-off pancreatic necrosis arise as a complication of pancreatitis. Multiple fluid collections are seen in 5-20% of the patients who have walled-off peripancreatic fluid collections. There is a paucity of data regarding the role of endoscopic transmural drainage in the management of multiple pancreatic fluid collections. In this case report, we present the case of a 72-year-old male with three walled-off pancreatic fluid collections in the setting of acute necrotizing pancreatitis...
January 9, 2018: Curēus
https://www.readbyqxmd.com/read/29519329/endoscopic-ultrasound-guided-drainage-of-pancreatic-fluid-collections
#16
REVIEW
Marc Giovannini
Ultrasound-guided drainage is the first-line modality for drainage of symptomatic of pancreatic fluid collections. In the context of pancreatic cancer, use of multiple double-pigtail plastic stents suffice, with high treatment efficacy. This approach provides similar success rates with low complications and better quality of life compared with surgery. Lumen apposing metallic stents (LAMSs) permit more effective drainage with larger diameter; because of their higher costs than plastic stents, their main role is probably in the context of walled-off necrosis, but the place and the use of LAMS should be studied to avoid and reduce the risks of complications...
April 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29497687/endoscopic-necrosectomy-of-walled-off-pancreatic-necrosis-by-large-bore-percutaneus-metal-stent-a-new-opportunity
#17
Andrea Tringali, Salvatore F Vadalà di Prampero, Vincenzo Bove, Vincenzo Perri, Antonio La Greca, Gilda Pepe, Valerio Cozza, Guido Costamagna
Background and study aims  Endoscopic drainage of walled-off pancreatic necrosis (WOPN) is feasible when contact with the gastric or duodenal wall is present; when WOPN cannot be accessed endoscopically, a percutaneous approach can be considered. Percutaneous use of esophageal self-expandable metal stents (SEMS) to establish access to a WOPN cavity was evaluated.
March 2018: Endoscopy International Open
https://www.readbyqxmd.com/read/29497684/multicenter-experience-from-the-uk-and-ireland-of-use-of-lumen-apposing-metal-stent-for-transluminal-drainage-of-pancreatic-fluid-collections
#18
Suresh Vasan Venkatachalapathy, Noor Bekkali, Stephen Pereira, Gavin Johnson, Kofi Oppong, Manu Nayar, John Leeds, Bharat Paranandi, Ian Penman, Nicholas Carroll, Edmund Godfrey, Martin James, Guruprasad Aithal, Colin McKay, John Devlin, Terry Wong, Alistair Makin, Barbara Ryan, Matthew Huggett
Background and study aims:  Pancreatic fluid collection (PFC) is a common complication of pancreatitis for which endoscopic ultrasound-guided drainage is first-line treatment. A new single-device, lumen-apposing, covered self-expanding metal stent (LAMS) has been licensed for PFC drainage. We therefore present our multicenter experience with the LAMS for PFC drainage in a multicenter prospective case series to assess success and complication rates. Patients and methods:  All adult patients from 11 tertiary centers who had LAMS placement for PFC from July 2015 to July 2016 were included...
March 2018: Endoscopy International Open
https://www.readbyqxmd.com/read/29496357/pancreatic-walled-off-necrosis-eroding-into-the-inferior-vena-cava
#19
Anupama Ramachandran, Sanchit Sharma, Shalimar, Raju Sharma, Kumble Seetharama Madhusudhan
Walled-off necrosis (WON) is a well-known delayed local complication of acute necrotizing pancreatitis. Occasionally, WON may spontaneously rupture into the gastrointestinal tract or peritoneal cavity. However, erosion of a WON to a systemic vein has not been reported in literature so far. We report an unusual case of a 63-year-old male with acute necrotizing pancreatitis in whom WON was eroding into the inferior vena cava resulting in its thrombosis. Our patient also had a bunch of other well-described complications of pancreatitis including splanchnic venous thrombosis...
February 2, 2018: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/29474970/increased-incidence-of-pseudoaneurysm-bleeding-with-lumen-apposing-metal-stents-compared-to-double-pigtail-plastic-stents-in-patients-with-peripancreatic-fluid-collections
#20
Bryan Brimhall, Samuel Han, Philip D Tatman, Toshimasa J Clark, Sachin Wani, Brian Brauer, Steven Edmundowicz, Mihir S Wagh, Augustin Attwell, Hazem Hammad, Raj J Shah
BACKGROUND & AIMS: There have been few studies that compared the effects of lumen-apposing metal stents (LAMS) and double-pigtail plastic stents (DPS) in patients with peripancreatic fluid collections from pancreatitis. We aimed to compare technical and clinical success and adverse events in patients who received LAMS vs DPS for pancreatic pseudocysts and walled-off necrosis. METHODS: We performed a retrospective study of endoscopic ultrasound-mediated drainage in 149 patients (65% male; mean age, 47 y) with pancreatic pseudocysts or walled-off necrosis (97 received LAMS and 152 received DPS), from January 2011 through September 2016 at a single center...
February 21, 2018: Clinical Gastroenterology and Hepatology
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