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necrosectomy pancreatic

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https://www.readbyqxmd.com/read/29221438/double-catheter-lavage-combined-with-percutaneous-flexible-endoscopic-debridement-for-infected-pancreatic-necrosis-failed-to-percutaneous-catheter-drainage
#1
Pi Liu, Jun Song, Hua-Jing Ke, Nong-Hua Lv, Yin Zhu, Hao Zeng, Yong Zhu, Liang Xia, Wen-Hua He, Ji Li, Xin Huang, Yu-Peng Lei
BACKGROUND: Infected pancreatic necrosis (IPN) is a serious local complication of acute pancreatitis, with high mortality. Minimally invasive therapy including percutaneous catheter drainage (PCD) has become the preferred method for IPN instead of traditional open necrosectomy. However, the efficacy of double-catheter lavage in combination with percutaneous flexible endoscopic debridement after PCD failure is unknown compared with surgical necrosectomy. METHODS: A total of 27 cases of IPN patients with failure PCD between Jan 2014 and Dec 2015 were enrolled in this retrospective cohort study...
December 8, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/29202002/a-comparison-of-outcomes-between-a-lumen-apposing-metal-stent-with-electrocautery-enhanced-delivery-system-and-a-bi-flanged-metal-stent-for-drainage-of-walled-off-pancreatic-necrosis
#2
Noor L H Bekkali, Manu K Nayar, John S Leeds, Richard M Charnley, Matthew T Huggett, Kofi W Oppong
Background and study aims:  Bi-flanged metal stents (BFMS) have shown promise in the drainage of walled-off pancreatic necrosis (WON), but their placement requires multiple steps and the use of other devices. More recently, a novel device consisting of a combined lumen-apposing metal stent (LAMS) and electrocautery-enhanced delivery system has been introduced. The aim of this study was to compare the placement and outcomes of the two devices. Patients and methods:  This was a retrospective review of consecutive patients undergoing endoscopic ultrasound-guided placement of BFMS or LAMS for drainage of symptomatic WON...
December 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/29190873/-segmental-portal-hypertension-with-splenic-vein-thrombosis-caused-by-pancreatitis
#3
Luis Franco-Avilés, Federico I Hernández-Rocha, Ulises Mercado, Cristian G Malvido-Torres
BACKGROUND: Splenic vein thrombosis is a complication of pancreatic carcinoma, pancreatitis or pancreatic pseudocyst. It may lead to segmental portal hypertension and bleeding from gastric varices. CLINICAL CASE: A 31 year-old man was diagnosed with pancreatitis of two weeks of evolution and was referred to our hospital in 2013. He had a history of alcohol consumption. Physical examination showed no stigmata of liver cirrhosis. Laboratory analyses revealed hemoglobin 9...
November 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/29109852/mortality-and-morbidity-in-necrotizing-pancreatitis-managed-on-principles-of-step-up-approach-7-years-experience-from-a-single-surgical-unit
#4
Deshpande Aparna, Sunil Kumar, Shukla Kamalkumar
AIM: To determine percentage of patients of necrotizing pancreatitis (NP) requiring intervention and the types of interventions performed. Outcomes of patients of step up necrosectomy to those of direct necrosectomy were compared. Operative mortality, overall mortality, morbidity and overall length of stay were determined. METHODS: After institutional ethics committee clearance and waiver of consent, records of patients of pancreatitis were reviewed. After excluding patients as per criteria, epidemiologic and clinical data of patients of NP was noted...
October 27, 2017: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29108721/endoscopic-or-surgical-step-up-approach-for-infected-necrotising-pancreatitis-a-multicentre-randomised-trial
#5
Sandra van Brunschot, Janneke van Grinsven, Hjalmar C van Santvoort, Olaf J Bakker, Marc G Besselink, Marja A Boermeester, Thomas L Bollen, Koop Bosscha, Stefan A Bouwense, Marco J Bruno, Vincent C Cappendijk, Esther C Consten, Cornelis H Dejong, Casper H van Eijck, Willemien G Erkelens, Harry van Goor, Wilhelmina M U van Grevenstein, Jan-Willem Haveman, Sijbrand H Hofker, Jeroen M Jansen, Johan S Laméris, Krijn P van Lienden, Maarten A Meijssen, Chris J Mulder, Vincent B Nieuwenhuijs, Jan-Werner Poley, Rutger Quispel, Rogier J de Ridder, Tessa E Römkens, Joris J Scheepers, Nicolien J Schepers, Matthijs P Schwartz, Tom Seerden, B W Marcel Spanier, Jan Willem A Straathof, Marin Strijker, Robin Timmer, Niels G Venneman, Frank P Vleggaar, Rogier P Voermans, Ben J Witteman, Hein G Gooszen, Marcel G Dijkgraaf, Paul Fockens
BACKGROUND: Infected necrotising pancreatitis is a potentially lethal disease and an indication for invasive intervention. The surgical step-up approach is the standard treatment. A promising alternative is the endoscopic step-up approach. We compared both approaches to see whether the endoscopic step-up approach was superior to the surgical step-up approach in terms of clinical and economic outcomes. METHODS: In this multicentre, randomised, superiority trial, we recruited adult patients with infected necrotising pancreatitis and an indication for invasive intervention from 19 hospitals in the Netherlands...
November 3, 2017: Lancet
https://www.readbyqxmd.com/read/29104650/predictive-factors-of-pancreatic-necrosectomy-following-percutaneous-catheter-drainage-as-a-primary-treatment-of-patients-with-infected-necrotizing-pancreatitis
#6
Xi Cao, Feng Cao, Ang Li, Xiang Gao, Xiao-Hui Wang, Dian-Gang Liu, Yu Fang, Dong-Hai Guo, Fei Li
Pancreatic necrosectomy (PN) following percutaneous catheter drainage (PCD) is an effective method of treating patients with necrotizing pancreatitis, however, the predictive factors for PN after PCD have not yet been identified. A total of 74 patients with suspected infected necrotizing pancreatitis (INP) and peripancreatic fluid collection were enrolled in the current study between October 2010 and October 2015. These patients received ultrasound or computer topography guided PCD followed by PN. Patients were divided into two groups: i) A PCD-alone group (n=32) and ii) a PCD+necrosectomy group (n=42)...
November 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29103188/management-of-inflammatory-fluid-collections-and-walled-off-pancreatic-necrosis
#7
REVIEW
Apeksha Shah, Richard Denicola, Cynthia Edirisuriya, Ali A Siddiqui
Pancreatic fluid collections are a frequent complication of acute pancreatitis. The revised Atlanta criterion classifies chronic fluid collections into pseudocysts and walled-off pancreatic necrosis (WON). Symptomatic PFCs require drainage options that include surgical, percutaneous, or endoscopic approaches. With the advent of newer and more advanced endoscopic tools and expertise, minimally invasive endoscopic drainage has now become the preferred approach. An endoscopic ultrasonography (EUS)-guided approach for pancreatic fluid collection drainage is now the preferred endoscopic approach...
December 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29101565/comparison-of-clinical-efficacies-and-safeties-of-lumen-apposing-metal-stent-and-conventional-type-metal-stent-assisted-eus-guided-pancreatic-wall-off-necrosis-drainage-a-real-life-experience-in-a-tertiary-hospital
#8
Siu Tong Law, Carlos De La SernaHiguera, Paula Gil Simón, Manuel Pérez-MirandaCastillo
BACKGROUND: Endoscopic ultrasound (EUS)-guided drainage of pancreatic wall-off necrosis (WON) with transmural stent is regarded as firstline therapy. We aimed at comparing its efficacy and safety with using fully covered self-expandable metal stent (FCSEMS) and lumen-apposing metal stent (LAMS). METHODS: A retrospective review was performed on all consecutive patients with pancreatic WONs who underwent EUS-guided drainage by either FCSEMS or LAMS. RESULTS: From 2011 to 2016, 68 patients (66...
November 3, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29099617/minimally-invasive-pancreatic-necrosectomy-a-technical-pictorial-review
#9
Gregory C Makris, Teikchoon See, Andrew Winterbottom, Asif Jah, Nadeem Shaida
Necrotizing pancreatitis is the most severe form of acute pancreatitis, which is associated with significant mortality and morbidity. Open necrosectomy has been one of the treatment modalities, however, several studies have shown high mortality rates to those undergoing early surgery. In this pictorial review we are presenting a minimally invasive procedure for the debridement of the necrotic pancreatic tissue. We will discuss the current evidence around the use of this procedure and we will describe the technique of minimally invasive pancreatic necrosectomy...
November 3, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/29095421/modern-management-of-pancreatic-fluid-collections
#10
Iman Andalib, Enad Dawod, Michel Kahaleh
The last decade has seen dramatic shift in paradigm in the management of pancreatic fluid collections with the rise of endoscopic therapy over radiologic or surgical management. Endosonographic drainage is now considered the gold standard therapy for pancreatic pseudocyst. Infected pancreatic necroses are being offered endoscopic necrosectomy that has been facilitated by the arrival on the market of large diameter lumen-apposing metal stent. Severe pancreatitis or failure to thrive should receive enteral nutrition while pancreatic ductal disruption or strictures are best treated by pancreatic stenting...
October 31, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29078869/transgastric-pancreatic-necrosectomy-expedited-return-to-prepancreatitis-health
#11
Monica M Dua, David J Worhunsky, Lavina Malhotra, Walter G Park, George A Poultsides, Jeffrey A Norton, Brendan C Visser
BACKGROUND: The best operative strategy for necrotizing pancreatitis remains controversial. Traditional surgical necrosectomy is associated with significant morbidity; endoscopic and percutaneous strategies require repeated interventions with prolonged hospitalizations. We have developed a transgastric approach to pancreatic necrosectomy to overcome the shortcomings of the other techniques described. MATERIALS AND METHODS: Patients with necrotizing pancreatitis treated from 2009 to 2016 at an academic center were retrospectively reviewed...
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29063871/a-multi-institutional-consensus-on-how-to-perform-endoscopic-ultrasound-guided-peri-pancreatic-fluid-collection-drainage-and-endoscopic-necrosectomy
#12
Jintao Guo, Adrian Saftoiu, Peter Vilmann, Pietro Fusaroli, Marc Giovannini, Girish Mishra, Surinder S Rana, Sammy Ho, Jan-Werner Poley, Tiing Leong Ang, Evangelos Kalaitzakis, Ali A Siddiqui, Jose G De La Mora-Levy, Sundeep Lakhtakia, Manoop S Bhutani, Malay Sharma, Shuntaro Mukai, Pramod Kumar Garg, Linda S Lee, Juan J Vila, Everson Artifon, Douglas G Adler, Siyu Sun
There is a lack of consensus on how endoscopic ultrasound (EUS)-guided pseudocyst drainage and endoscopic necrosectomy should be performed. This survey was carried out amongst members of the EUS Journal Editorial Board to describe their practices in performing this procedure. This was a worldwide multi-institutional survey amongst members of the EUS Journal Editorial Board in May 2017. The responses to a 22-question survey with respect to the practice of EUS-guided pseudocyst drainage and endoscopic necrosectomy were obtained...
September 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/29056844/extended-cystogastrostomy-with-hydrogen-peroxide-irrigation-facilitates-endoscopic-pancreatic-necrosectomy
#13
Mohamed O Othman, Sherif Elhanafi, Mohammed Saadi, Christine Yu, Brian R Davis
INTRODUCTION: Walled-off pancreatic necrosis (WOPN) is a major complication of acute pancreatitis. We hypothesized that an extended (2 cm) cystogastrostomy opening combined with hydrogen peroxide irrigation can increase the success of endoscopic necrosectomy and decrease the number of required endoscopic interventions. The aim of the study is to assess the safety and feasibility of the technique in the management of WOPN. METHODS: This is a retrospective chart review of all cases that underwent EUS with extended cystogastrostomy and hydrogen peroxide irrigation prior to necrosectomy in a tertiary referral medical center...
2017: Diagnostic and Therapeutic Endoscopy
https://www.readbyqxmd.com/read/29019583/management-of-infected-pancreatic-necrosis-state-of-the-art
#14
Roberto Rasslan, Fernando da Costa Ferreira Novo, Alberto Bitran, Edivaldo Massazo Utiyama, Samir Rasslan
Pancreatic necrosis occurs in 15% of acute pancreatitis. The presence of infection is the most important factor in the evolution of pancreatitis. The diagnosis of infection is still challenging. Mortality in infected necrosis is 20%; in the presence of organic dysfunction, mortality reaches 60%. In the last three decades, there has been a real revolution in the treatment of infected pancreatic necrosis. However, the challenges persist and there are many unsolved questions: antibiotic treatment alone, tomography-guided percutaneous drainage, endoscopic drainage, video-assisted extraperitoneal debridement, extraperitoneal access, open necrosectomy? A step up approach has been proposed, beginning with less invasive procedures and reserving the operative intervention for patients in which the previous procedure did not solve the problem definitively...
September 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28971378/endoscopic-ultrasound-guided-transmural-drainage-of-walled-off-pancreatic-necrosis-in-patients-with-portal-hypertension-and-intra-abdominal-collaterals
#15
Surinder S Rana, Ravi Sharma, Sobur Uddin Ahmed, Rajesh Gupta
BACKGROUND: Acute necrotizing pancreatitis (ANP) is complicated with segmental portal hypertension (PHT) and formation of venous collaterals. Presence of collaterals in vicinity of endoscopic transmural tract can lead to potentially catastrophic situation. Here, we report safety and outcome of EUS-guided transmural drainage of walled-off pancreatic necrosis (WOPN) in patients with PHT and intra-abdominal collaterals. METHODS: Retrospective analysis of collected database of patients (n=18; age 40...
October 2, 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28948113/one-of-the-largest-pancreatic-pseudocysts-in-the-literature-a-case-report
#16
Sulaiman Alhassan, Shifa Umar, Mark Lega
The pancreatic pseudocyst is a pancreatic fluid collection which classically develops due to acute or chronic pancreatitis. A 68-year-old male with the remote history of alcohol abuse presented with abdominal pain secondary to acute pancreatitis. The first computed tomography (CT) of the abdomen showed acute necrotizing pancreatitis. He was initially treated conservatively. Repeat CT of the abdomen after two weeks revealed a peripancreatic fluid collection of 20x12x10 cm. One month later, he became septic following biliary stent placement...
July 20, 2017: Curēus
https://www.readbyqxmd.com/read/28924589/can-we-now-recommend-hydrogen-peroxide-for-pancreatic-necrosectomy-time-for-controlled-data
#17
EDITORIAL
Patrick Yachimski
No abstract text is available yet for this article.
September 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28924588/endoscopic-pancreatic-necrosectomy-why-scuff-when-you-can-flush-the-muck-make-it-an-easy-row-to-hoe
#18
Rinkesh Kumar Bansal, Rajesh Puri, Narendra S Choudhary, Sumit Bhatia, Nisharg Patel, Saurabh K Patle, Gaurav K Patil, Amit Agarwal, Chandra Prabha, Randhir Sud
BACKGROUND AND AIMS:  Endoscopic ultrasound (EUS) guided drainage of symptomatic pancreatic walled-off necrosis (WON) followed by fully covered self-expanding metal stent (FCSEMS) placement offers several advantages such as higher technical success rate and the option of necrosectomy. The aim of this study was to evaluate the safety and efficacy of EUS guided drainage of patients with WON by using FCSEMS and intracavitary lavage with a solution containing hydrogen peroxide and adopting a step-up approach...
September 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28918807/endoscopic-ultrasonography-guided-drainage-of-pancreatic-collections-including-the-role-of-necrosectomy
#19
REVIEW
Ryan Law, Todd H Baron
In recent years, the management of symptoms of pancreatic fluid collections has shifted from surgical and percutaneous interventions to endoscopic techniques. Available data show that endoscopic drainage can be achieved with minimal morbidity and procedural-related mortality, a high degree of technical and clinical success, and acceptable risk of adverse events. Although endoscopic management of walled-off necrosis provides a durable, minimally invasive treatment option, it is still generally performed only in tertiary care medical centers because of the overall complexity of this clinical scenario...
October 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28858947/is-transcutaneous-endoscopic-necrosectomy-appropriate-method-in-managing-all-patients-with-walled-off-pancreatic-necrosis-that-extend-into-the-paracolic-gutter
#20
Enver Zerem, Predrag Jovanović, Mirza Omerović, Dženan Jahić, Dina Zerem, Omar Zerem
No abstract text is available yet for this article.
August 30, 2017: Journal of Clinical Gastroenterology
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