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Walled off necrosis

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https://www.readbyqxmd.com/read/27908599/prospective-evaluation-of-a-new-biflanged-metal-stent-for-the-treatment-of-pancreatic-fluid-collections-with-videos
#1
Shuntaro Mukai, Takayoshi Tsuchiya, Takao Itoi, Shujiro Tsuji, Reina Tanaka, Ryosuke Tonozuka, Yuichi Nagakawa, Kazuhiko Kasuya, Masaaki Shimatani, Atsushi Sofuni
BACKGROUND AND AIMS: EUS-guided transluminal drainage (EUS-TD) and sequential direct endoscopic necrosectomy (DEN) for pancreatic fluid collections (PFCs) using a dedicated biflanged metal stent (BFMS) has been reported as a useful alternative to using plastic stents or a conventional metal stent. However, current dedicated BFMSs have limitations. Recently, a new BFMS with solidly constructed biflanges and various stent lengths matched to the PFC condition has been developed. Herein, we prospectively evaluated this new BFMS for the treatment of PFCs...
November 28, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27899271/the-role-of-transpapillary-drainage-in-management-of-patients-with-pancreatic-fluid-collections-and-pancreatic-duct-disruption-as-a-consequences-of-severe-acute-pancreatitis
#2
EDITORIAL
Mateusz Jagielski, Marian Smoczyński, Krystian Adrych
In last thirty years we have been observing significant development of an endoscopic treatment of pancreatic fluid collections, including transmural drainage of walled-off pancreatic necrosis. Simultaneously, the use of endotherapy in treatment of main pancreatic ducts disruptions has increased. Despite many publications available in current literature, concerning the endoscopic treatment of consequences of acute necrotizing pancreatitis, the role of transpapillary drainage in management of patients with pancreatic fluid collections and pancreatic duct disruption as an after-effect of severe acute pancreatitis remains unclear and is still a current problem...
November 18, 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/27868439/-the-treatment-of-walled-off-pancreatic-necrosis-review
#3
Zsolt Szentkereszty, Klaudia Balog, Lídia Balázs, Adrien Csiszkó
: Walled-off pancreatic necrosis is a late complication of severe acute pancreatitis that generally needs some interventions. The aim of this review is to analyse the indications, technical aspects and limits of these therapeutic options. The development of the walled-off pancreatic necrosis needs 4-6 weeks from the onset of the disease. The necrosectomy is recommended after this time. Endoscopic necrosectomy offers good results if the necrosis is in retrogastric or retroduodenal localisations...
November 2016: Orvosi Hetilap
https://www.readbyqxmd.com/read/27852082/intraductal-necrosectomy-for-pancreatic-walled-off-necrosis-using-novel-single-operator-pancreatoscope
#4
Takeshi Ogura, Wataru Takagi, Saori Onda, Tastsushi Sano, Kazuhide Higuchi
No abstract text is available yet for this article.
January 2016: Endoscopy
https://www.readbyqxmd.com/read/27849658/impact-of-disconnected-pancreatic-duct-syndrome-on-the-endoscopic-management-of-pancreatic-fluid-collections
#5
Ji Young Bang, Charles Melbern Wilcox, Udayakumar Navaneethan, Muhammad K Hasan, Shajan Peter, John Christein, Robert Hawes, Shyam Varadarajulu
OBJECTIVE: To study the effect of disconnected pancreatic duct syndrome (DPDS) on endoscopic management of pancreatic fluid collections (PFCs). BACKGROUND: Data on the impact of DPDS in patients undergoing endoscopic treatment of PFCs are limited. METHODS: Retrospective study of patients undergoing endoscopic drainage of PFCs from 2003 to 2015. If treatment response was suboptimal following initial endoscopic or endoscopic ultrasound-guided transmural drainage, hybrid interventions (endoscopic ultrasound-guided multigate/dual modality technique, endoscopic/percutaneous sinus tract necrosectomy) were performed...
November 15, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27845053/endoscopic-step-up-approach-using-a-dedicated-bi-flanged-metal-stent-reduces-the-need-for-direct-necrosectomy-in-walled-off-necrosis-with-videos
#6
Sundeep Lakhtakia, Jahangeer Basha, Rupjyoti Talukdar, Rajesh Gupta, Zaheer Nabi, Mohan Ramchandani, B V N Kumar, Partha Pal, Rakesh Kalpala, Manohar Reddy, R Pradeep, Jagadeesh Singh, G V Rao, D Nageshwar Reddy
BACKGROUND: EUS-guided drainage using plastic stents may be inadequate for treatment of WON. Recent studies report variable outcomes even using covered metal stent. AIM: The aim of this study was to evaluate the efficacy of a dedicated covered bi-flanged metal stent (BFMS) when adopting endoscopic "step-up approach" for drainage of symptomatic WON. METHODS: We retrospectively evaluated consecutive patients with symptomatic WON who underwent EUS-guided drainage using BFMSs over a 3-year period...
November 11, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27805963/outcome-of-acute-pancreatic-and-peripancreatic-collections-occurring-in-patients-with-acute-pancreatitis
#7
Manish Manrai, Rakesh Kochhar, Vikas Gupta, Thakur Deen Yadav, Narendra Dhaka, Naveen Kalra, Saroj K Sinha, Niranjan Khandelwal
OBJECTIVE: To study the outcome of acute collections occurring in patients with acute pancreatitis BACKGROUND:: There are limited data on natural history of acute collections arising after acute pancreatitis (AP). METHODS: Consecutive patients of AP admitted between July 2011 and December 2012 were evaluated by imaging for development of acute collections as defined by revised Atlanta classification. Imaging was repeated at 1 and 3 months. Spontaneous resolution, evolution, and need for intervention were assessed...
November 1, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27803905/a-two-center-comparative-study-of-plastic-and-lumen-apposing-large-diameter-self-expandable-metallic-stents-in-endoscopic-ultrasound-guided-drainage-of-pancreatic-fluid-collections
#8
Tiing Leong Ang, Pradermchai Kongkam, Andrew Boon Eu Kwek, Piyachai Orkoonsawat, Rungsun Rerknimitr, Kwong Ming Fock
BACKGROUND AND OBJECTIVES: Endoscopic ultrasound-guided drainage of walled-off pancreatic fluid collections (PFCs) (pseudocyst [PC]; walled-off necrosis [WON]) utilizes double pigtail plastic stents (PS) and the newer large diameter fully covered self-expandable stents (FCSEMS) customized for PFC drainage. This study examined the impact of type of stent on clinical outcomes and costs. PATIENTS AND METHODS: Retrospective two-center study. Outcome variables were technical and clinical success, need for repeat procedures, need for direct endoscopic necrosectomy (DEN), and procedure-related costs...
September 2016: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/27747936/transmural-drainage-approaches-for-pancreatic-necrosis-a-changing-of-the-guard
#9
Kartik Sampath, Timothy B Gardner
Acute pancreatitis represents one of the most common gastrointestinal illnesses requiring inpatient hospitalization. An estimated twenty percent of these patients eventually develop pancreatic necrosis. Necrosis management consists of surveillance imaging, where necrosectomy is indicated for symptomatic or infected walled off necrosis (WON). Over the past two decades, the standard of care to manage WON has switched from an open operative approach to an endoscopic, minimally-invasive, step-up method [1] [2]...
October 16, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/27678352/management-of-patients-after-recovering-from-acute-severe-biliary-pancreatitis
#10
REVIEW
Georgia Dedemadi, Manolis Nikolopoulos, Ioannis Kalaitzopoulos, George Sgourakis
Cholelithiasis is the most common cause of acute pancreatitis, accounting 35%-60% of cases. Around 15%-20% of patients suffer a severe attack with high morbidity and mortality rates. As far as treatment is concerned, the optimum method of late management of patients with severe acute biliary pancreatitis is still contentious and the main question is over the correct timing of every intervention. Patients after recovering from an acute episode of severe biliary pancreatitis can be offered alternative options in their management, including cholecystectomy, endoscopic retrograde cholangiopancreatography (ERCP) and sphincterotomy, or no definitive treatment...
September 14, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27665262/endoscopic-ultrasonography-guided-drainage-combined-with-trans-duodenoscope-cyclic-irrigation-technique-for-walled-off-pancreatic-necrosis
#11
Ying-Chun Ren, Su-Min Chen, Xiao-Bo Cai, Bai-Wen Li, Xin-Jian Wan
BACKGROUND: Endoscopic ultrasonography-guided drainage has been established as a good treatment modality in the management of walled-off pancreatic necrosis, but the unmanageable infection of postoperation is still a thorny problem due to the poor drainage ability for solid necrotic debris only through transmural stent and nasocystic catheter. AIMS: Introduce a novel therapeutic method, namely endoscopic ultrasonography-guided drainage combined with cyclic irrigation technique in managing patients with walled-off pancreatic necrosis...
September 1, 2016: Digestive and Liver Disease
https://www.readbyqxmd.com/read/27651917/case-report-of-eus-guided-endoscopic-transduodenal-necrosectomy-in-a-patient-with-sleeve-gastrectomy
#12
Avik Sarkar, Ragui Sadek, Matthew Lissauer, Swati Pawa
BACKGROUND: After an acute attack of pancreatitis, walled-off pancreatic fluid collections (PFC) occur in approximately 10 % of cases. Drainage of the cavity is recommended when specific indications are met. Endoscopic drainage has been adopted as the main intervention for symptomatic walled-off PFC. Altered gastric anatomy in these patients poses an interesting challenge. We present the first case of a patient with sleeve gastrectomy who underwent successful endoscopic transduodenal necrosectomy (TDN)...
2016: BMC Obesity
https://www.readbyqxmd.com/read/27627636/the-role-of-endoscopic-ultrasound-in-the-management-of-intraductal-papillary-mucinous-neoplasms-a-systematic-update
#13
Lyn A Smith, Colin J McKay
The widespread use of cross-sectional imaging has led to an increased frequency of incidentally detected pancreatic cysts. Neoplastic cysts such as mucinous lesions and solid pseudo-papillary neoplasms have malignant potential and therefore the early detection of these lesions presents an opportunity for prevention or early detection and management of pancreatic adenocarcinoma. Serous neoplastic lesions and non-neoplastic pancreatic cysts such as pseudocysts or walled off pancreatic necrosis and are not associated with malignant potential...
December 2016: Minerva Medica
https://www.readbyqxmd.com/read/27622199/bleeding-risk-of-stent-removal-after-eus-guided-cystgastrostomy-and-metal-stent-placement-for-drainage-of-a-pancreatic-fluid-collection
#14
Farid Jalali, Jason Samarasena, John G Lee
Endoscopists are keenly aware of bleeding risks during and immediately after cystgastrostomy and reduce this risk by endoscopic ultrasound guidance to avoid manipulation near major vessels. Bleeding risk associated with cystgastrostomy stent removal after resolution of a pancreatic fluid collection, however, is less evident. We present our experience with bleeding during cystgastrostomy stent removal in a patient with resolved walled-off necrosis and will discuss the significance of unexplained spontaneous upper gastrointestinal bleeding in this setting, which may serve as a warning sign for possible stent erosion into major vessels...
July 2016: ACG Case Reports Journal
https://www.readbyqxmd.com/read/27605870/management-of-acute-pancreatitis-in-japan-analysis-of-nationwide-epidemiological-survey
#15
EDITORIAL
Shin Hamada, Atsushi Masamune, Tooru Shimosegawa
Acute pancreatitis (AP) is an acute inflammatory disease of the exocrine pancreas. In Japan, nationwide epidemiological surveys have been conducted every 4 to 5 years by the Research Committee of Intractable Pancreatic Diseases, under the support of the Ministry of Health, Labour, and Welfare of Japan. We reviewed the results of the nationwide surveys focusing on the severity assessment and changes in the therapeutic strategy for walled-off necrosis. The severity assessment system currently used in Japan consists of 9 prognostic factors and the imaging grade on contrast-enhanced computed tomography...
July 28, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27594995/predictors-of-successful-non-operative-management-of-grade-iii-iv-blunt-pancreatic-trauma
#16
Suman B Koganti, Ravikanth Kongara, Sateesh Boddepalli, Naushad Shaik Mohammad, Venumadhav Thumma, Bheerappa Nagari, R A Sastry
INTRODUCTION: Although surgery is the preferred treatment for grade III&IV pancreatic trauma, there is a growing movement for non-operative management. in blunt pancreatic trauma. Very few studies compare operative versus non-operative management in adult patients. METHODS: Retrospective analysis of a prospectively maintained database was performed from 2004 to 2013 in the department of gastrointestinal surgery, NIMS, Hyderabad. Comparative analysis was performed between patients who failed versus those who were successfully managed with non-operative management...
September 2016: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/27566053/fully-covered-self-expanding-metal-stents-versus-lumen-apposing-fully-covered-self-expanding-metal-stent-versus-plastic-stents-for-endoscopic-drainage-of-pancreatic-walled-off-necrosis-clinical-outcomes-and-success
#17
Ali A Siddiqui, Thomas E Kowalski, David E Loren, Ammara Khalid, Ayesha Soomro, Syed M Mazhar, Laura Isby, Michel Kahaleh, Kunal Karia, Joseph Yoo, Andrew Ofosu, Beverly Ng, Reem Z Sharaiha
BACKGROUND AND AIMS: Endoscopic transmural drainage/debridement of pancreatic walled-off necrosis (WON) has been performed using double-pigtail plastic (DP), fully covered self-expanding metal stents (FCSEMSs), or the novel lumen-apposing fully covered self-expanding metal stent (LAMS). Our aim was to perform a retrospective cohort study to compare the clinical outcomes and adverse events of EUS-guided drainage/debridement of WON with DP stents, FCSEMSs, and LAMSs. METHODS: Consecutive patients in 2 centers with WON managed by EUS-guided debridement were divided into 3 groups: (1) those who underwent debridement using DP stents, (2) debridement using FCSEMSs, (3) debridement using LAMSs...
August 24, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27548251/endoscopic-treatment-of-walled-off-necrosis-in-children-clinical-experience-and-treatment-outcomes
#18
Ji Young Bang, Shyam Varadarajulu
OBJECTIVES: Data on the endoscopic treatment outcomes for walled-off necrosis (WON) in children are limited. The aim of the present study was to evaluate the efficacy and safety of endoscopic approach for the treatment of WON in children. METHODS: A retrospective study was conducted of all children with symptomatic WON treated endoscopically over 6 years. Treatment consisted of endoscopic ultrasound-guided transmural drainage using either a lumen-apposing metal stent or multiple 7Fr double pigtail plastic stents with or without percutaneous drainage...
September 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/27540578/eus-correlates-of-disconnected-pancreatic-duct-syndrome-in-walled-off-necrosis
#19
Ji Young Bang, Udayakumar Navaneethan, Muhammad K Hasan, Robert H Hawes, Shyam Varadarajulu
BACKGROUND AND STUDY AIMS: Although the diagnostic features of disconnected pancreatic duct syndrome (DPDS) by computed tomography (CT) and magnetic/endoscopic retrograde cholangiopancreatography (MRCP/ERCP) have been established, no such characterization exists for endoscopic ultrasound (EUS). This study describes the imaging features of EUS that accurately define DPDS. PATIENTS AND METHODS: This is a prospective study comprising 21 of 42 patients who underwent EUS-guided drainage of walled-off necrosis (WON) over an 18-month period...
August 2016: Endoscopy International Open
https://www.readbyqxmd.com/read/27518465/fungal-infections-in-patients-with-walled-off-pancreatic-necrosis
#20
Mikkel Werge, Stine Roug, Srdan Novovic, Palle Nordblad Schmidt, Erik Feldager Hansen, Jenny Dahl Knudsen
OBJECTIVES: This study aimed to evaluate the influence of fungal infection and antifungal treatment on outcome in patients with walled-off pancreatic necrosis (WON). METHODS: A retrospective description of fungal infections in a cohort of consecutive patients undergoing endoscopic, transmural drainage and necrosectomy for WON, treated in a tertiary referral center was reviewed. RESULTS: Between 2005 and 2013, fungal infection in WON was documented in 57 (46%) of 123 patients...
November 2016: Pancreas
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