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https://www.readbyqxmd.com/read/28516758/necrotizing-pancreatitis-current-management-and-therapies
#1
Christine Boumitri, Elizabeth Brown, Michel Kahaleh
Acute necrotizing pancreatitis accounts for 10% of acute pancreatitis (AP) cases and is associated with a higher mortality and morbidity. Necrosis within the first 4 weeks of disease onset is defined as an acute necrotic collection (ANC), while walled off pancreatic necrosis (WOPN) develops after 4 weeks of disease onset. An infected or symptomatic WOPN requires drainage. The management of pancreatic necrosis has shifted away from open necrosectomy, as it is associated with a high morbidity, to less invasive techniques...
May 16, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28494574/endoscopic-management-of-peri-pancreatic-fluid-collections
#2
REVIEW
Hon Chi Yip, Anthony Yuen Bun Teoh
In the past decade, there has been a progressive paradigm shift in the management of peri-pancreatic fluid collections after acute pancreatitis. Refinements in the definitions of fluid collections from the updated Atlanta classification have enabled better communication amongst physicians in an effort to formulate optimal treatments. Endoscopic ultrasound (EUS)-guided drainage of pancreatic pseudocysts has emerged as the procedure of choice over surgical cystogastrostomy. The approach provides similar success rates with low complications and better quality of life compared with surgery...
May 12, 2017: Gut and Liver
https://www.readbyqxmd.com/read/28487603/endoscopic-management-of-pancreatic-fluid-collections-revisited
#3
REVIEW
Zaheer Nabi, Jahangeer Basha, D Nageshwar Reddy
The development of pancreatic fluid collections (PFC) is one of the most common complications of acute severe pancreatitis. Most of the acute pancreatic fluid collections resolve and do not require endoscopic drainage. However, a substantial proportion of acute necrotic collections get walled off and may require drainage. Endoscopic drainage of PFC is now the preferred mode of drainage due to reduced morbidity and mortality as compared to surgical or percutaneous drainage. With the introduction of new metal stents, the efficiency of endoscopic drainage has improved and the task of direct endoscopic necrosectomy has become easier...
April 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28457332/comparison-between-minimally-invasive-and-open-surgical-treatment-in-necrotizing-pancreatitis
#4
Marek Wroński, Włodzimierz Cebulski, Bartosz Witkowski, Mieczysław Jankowski, Andrzej Kluciński, Ireneusz W Krasnodębski, Maciej Słodkowski
BACKGROUND: Minimal access techniques have gained popularity for the management of necrotizing pancreatitis, but only a few studies compared open necrosectomy with a less invasive treatment. The aim of this study was to evaluate the outcomes of minimally invasive treatment for necrotizing pancreatitis in comparison with open necrosectomy. MATERIALS AND METHODS: This retrospective study included 70 patients who underwent minimally invasive intervention or open surgical debridement for necrotizing pancreatitis between January 2007 and December 2014...
April 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28452889/surgical-management-of-pancreatic-necrosis-a-practice-management-guideline-from-the-eastern-association-for-the-surgery-of-trauma
#5
Nathan T Mowery, Brandon R Bruns, Heather MacNew, Suresh Agarwal, Toby Enniss, Mansoor Khan, Weidun Alan Guo, Jeremy W Cannon, Matthew Lissauer, Therese M Duane, Amy N Hildreth, Peter Pappas, Lynn Gries, Meghann Kaiser, Bryce Robinson
BACKGROUND: Pancreatic or peripancreatic tissue necrosis confers substantial morbidity and mortality. New modalities have created a wide variation in approaches and timing of interventions for necrotizing pancreatitis. As acute care surgery evolves, its practitioners are increasingly being called upon to manage these complex patients. METHODS: A systematic review of the MEDLINE database using PubMed was performed. English language articles regarding pancreatic necrosis from 1980 to 2014 were included...
April 27, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28411344/the-effect-of-a-novel-minimally-invasive-strategy-for-infected-necrotizing-pancreatitis
#6
Zhihui Tong, Xiao Shen, Lu Ke, Gang Li, Jing Zhou, Yiyuan Pan, Baiqiang Li, Dongliang Yang, Weiqin Li, Jieshou Li
BACKGROUND: Step-up approach consisting of multiple minimally invasive techniques has gradually become the mainstream for managing infected pancreatic necrosis (IPN). In the present study, we aimed to compare the safety and efficacy of a novel four-step approach and the conventional approach in managing IPN. METHODS: According to the treatment strategy, consecutive patients fulfilling the inclusion criteria were put into two time intervals to conduct a before-and-after comparison: the conventional group (2010-2011) and the novel four-step group (2012-2013)...
April 14, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28391671/endoscopic-ultrasound-guided-management-of-pancreatic-fluid-collections-update-and-review-of-the-literature
#7
REVIEW
Ali Alali, Jeffrey Mosko, Gary May, Christopher Teshima
Severe acute pancreatitis is often complicated by the development of pancreatic fluid collections (PFCs), which may be associated with significant morbidity and mortality. It is crucial to accurately classify these collections as a pseudocyst or walled-off necrosis (WON) given significant differences in outcomes and management. Interventions for PFCs have increasingly shifted to less invasive strategies, with endoscopic ultrasound (EUS)-guided methods being shown to be safer and equally effective as more invasive surgical techniques...
March 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28381378/severe-acute-pancreatitis-pathogenesis-diagnosis-and-surgical-management
#8
Mark Portelli, Christopher David Jones
BACKGROUND: Severe acute pancreatitis is a subtype of acute pancreatitis, associated with multiple organ failure and systemic inflammatory response syndrome. In this qualitative review we looked at the principles of pathogenesis, classification and surgical management of severe acute pancreatitis. We also looked at the current shift in paradigm in the management of severe acute pancreatitis since the guideline developed by the British Society of Gastroenterology. DATA SOURCES: Studies published between 1st January 1991 and 31st December 2015 were identified with PubMed, MEDLINE, EMBASE and Google Scholar online search engines using the following Medical Subject Headings: "acute pancreatitis, necrosis, mortality, pathogenesis, incidence" and the terms "open necrosectomy and minimally invasive necrosectomy"...
April 2017: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/28348985/current-concepts-in-the-management-of-acute-pancreatitis
#9
REVIEW
Gautham Srinivasan, L Venkatakrishnan, Swaminathan Sambandam, Gursharan Singh, Maninder Kaur, Krishnaveni Janarthan, B Joseph John
Guidelines for the management of acute pancreatitis (AP) are based on the Western experience, which may be difficult to extrapolate in India due to socioeconomic constraints. Hence, modifications based on the available resources and referral patterns should be introduced so as to ensure appropriate care. We reviewed the current literature on the management of AP available in English on Medline and proposed guidelines locally applicable. Patients of AP presenting with systemic inflammatory response syndrome are at risk of moderate-severe pancreatitis and hence, should be referred to a tertiary center early...
October 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28331537/combined-totally-mini-invasive-approach-in-necrotizing-pancreatitis-a-case-report-and-systematic-literature-review
#10
REVIEW
Luca Sorrentino, Osvaldo Chiara, Massimiliano Mutignani, Fabrizio Sammartano, Paolo Brioschi, Stefania Cimbanassi
BACKGROUND: Currently, both the step-up approach, combining percutaneous drainage (PD) and video-assisted retroperitoneal debridement (VARD), and endoscopic transgastric necrosectomy (ETN) are mini-invasive techniques for infected necrosis in severe acute pancreatitis. A combination of these approaches could maximize the management of necrotizing pancreatitis, conjugating the benefits from both the experiences. However, reporting of this combined strategy is anecdotal. This is the first reported case of severe necrotizing pancreatitis complicated by biliary fistula treated by a combination of ETN, PD, VARD, and endoscopic biliary stenting...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28205028/the-outcomes-of-initial-endoscopic-transluminal-drainage-are-superior-to-percutaneous-drainage-for-patients-with-infected-pancreatic-necrosis-a-prospective-cohort-study
#11
Wen-Hua He, Yong Zhu, Yin Zhu, Pi Liu, Hao Zeng, Liang Xia, Chen Yu, Hai-Ming Chen, Xu Shu, Zhi-Jian Liu, You-Xiang Chen, Nong-Hua Lu
BACKGROUND AND STUDY AIM: The commonly used minimally invasive methods for patients with infected pancreatic necrosis (IPN) are initial endoscopic transluminal drainage (ETD) and percutaneous catheter drainage (PCD), which are followed, if necessary, by endoscopic or surgical necrosectomy. This study intends to explore which of the two minimally invasive treatments leads to a better prognosis. PATIENTS AND METHODS: Patients with IPN and an indication for intervention were prospectively enrolled and underwent either initial ETD or PCD followed, if necessary, by endoscopic or surgical necrosectomy...
February 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28202234/endoscopic-ultrasound-guided-transmural-drainage-of-walled-off-pancreatic-necrosis-using-a-step-up-approach-a-single-centre-experience
#12
Surinder S Rana, Vishal Sharma, Ravi Sharma, Rajesh Gupta, Deepak K Bhasin
BACKGROUND: Walled off necrosis (WON) can be treated endoscopically using multiple transmural plastic stents or fully covered self-expandable metallic stent (FCSEMS) and direct endoscopic necrosectomy (DEN). We evaluated the efficacy of "step-up" endoscopic transmural approach for treatment of WON. METHODS: Retrospective analysis of data of 86 patients with WON who were treated with attempted endoscopic ultrasound (EUS) guided "step up" transmural drainage during last 5 years was done...
March 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28196022/proactive-versus-standard-percutaneous-catheter-drainage-for-infected-necrotizing-pancreatitis
#13
Janneke van Grinsven, Pieter Timmerman, Krijn P van Lienden, Jan Willem Haveman, Djamila Boerma, Casper H J van Eijck, Paul Fockens, Hjalmar C van Santvoort, Marja A Boermeester, Marc G Besselink
OBJECTIVES: Percutaneous catheter drainage (PCD) is often the first invasive treatment step for infected necrotizing pancreatitis. A proactive PCD strategy, including frequent and early drain revising and upsizing, may reduce the need for surgical necrosectomy and could improve outcomes, but data are lacking. METHODS: Necrotizing pancreatitis patients were identified from in-hospital databases (2004-2014). Patients with primary PCD for infected necrotizing pancreatitis were included...
April 2017: Pancreas
https://www.readbyqxmd.com/read/28193088/scrotal-abscess-a-rare-presentation-of-complicated-necrotizing-pancreatitis
#14
Seyyedhadi Mirhashemi, Mohsen Soori, Gholamhossein Faghih, Hassan Peyvandi, Omid Shafagh
Acute pancreatitis is characterized by activation of digestive enzymes inside the pancreas. In severe pancreatitis, necrosis of pancreas and surrounding tissues may occur. Acute necrotizing pancreatitis commonly presents as pancreatic abscess occasionally with systemic complications. Rarely, necrotic tissue may be drained from scrotum due to retroperitoneal extension of necrotic process. Here, we report a case of acute necrotizing pancreatitis in a 29-year-old man who presented with severe abdominal pain, nausea and vomiting...
February 2017: Archives of Iranian Medicine
https://www.readbyqxmd.com/read/28180976/-video-assisted-retroperitoneal-debridement-minimally-invasive-treatment-and-long-term-results-for-necrotizing-pancreatitis
#15
R M Eickhoff, J Steinbusch, P Seppelt, A Kroh, K Junge, C D Klink, U P Neumann, M Binnebösel
BACKGROUND: Among patients with necrotizing pancreatitis 15-20% develop infected necrosis, which entails mortality rates of up to 20%. Particularly driven by the results of the Dutch Pancreatitis Study Group there has been a paradigm change from open necrosectomy to step-up treatment with initial percutaneous and/or endoscopic drainage followed, if necessary, by minimally invasive retroperitoneal debridement. AIM OF THE STUDY: Description of case series in which patients underwent video-assisted retroperitoneal debridement (VARD) including follow-up focused on quality of life...
February 8, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28142159/the-buried-stent-a-rare-complication-of-endoscopic-ultrasound-guided-pancreatic-necrosectomy-using-a-lumen-apposing-metal-stent
#16
Ahmed Y Altonbary, Hazem Hakim
No abstract text is available yet for this article.
February 2017: Endoscopy
https://www.readbyqxmd.com/read/28133066/-a-case-of-bismuth-iii-b-hilar-cholangiocarcinoma-resected-with-extended-left-hepatic-lobectomy-after-ercp-induced-pancreatitis
#17
Toru Mizutani, Hisashi Ikoma, Toshiyuki Kosuga, Hirotaka Konishi, Ryo Morimura, Yasutoshi Murayama, Shuhei Komatsu, Atsushi Shiozaki, Yoshiaki Kriu, Masayoshi Nakanishi, Daisuke Ichikawa, Hitoshi Fujiwara, Kazuma Okamoto, Toshiya Ochiai, Eigo Otsuji
Endoscopic retrograde cholangiopancreatography(ERCP)is widely accepted as the standard therapy before surgery for hilar cholangiocarcinoma. The patient is a 68-year-old man who presented with liver dysfunction. Computed tomography (CT)revealed abnormal lesions in his liver. He was referred to our hospital for therapy. We present a rare case of expansion of left lobectomy for Bismuth III b hilar cholangiocarcinoma after grade 2 severe pancreatitis caused by ERCP. He received arterial infusion therapy and endoscopic necrosectomy 6 times and percutaneous transhepatic biliary drainage(PTBD)...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28112447/flexible-percutaneous-endoscopic-retroperitoneal-necrosectomy-as-rescue-therapy-for-pancreatic-necroses-beyond-the-reach-of-endoscopic-ultrasonography-a-case-series
#18
Christian Jürgensen, Stefan Brückner, Stephanie Reichel, Maik Kilian, Sven Pannach, Marius Distler, Jürgen Weitz, Frank Neser, Jochen Hampe, Uwe Will
Minimally invasive or endoscopic transluminal drainage and necrosectomy are the standard of care for infected pancreatic fluid collections and necroses after pancreatitis. In an endoscopic treatment algorithm, necroses beyond the reach of safe endoscopic access are typically treated by percutaneous drainage. We aimed to evaluate percutaneous minimally invasive necrosectomy using a purely endoscopic technique in patients with extensive necrosis. In patients with necroses beyond safe transluminal reach, the percutaneous drainage canal was used for flexible endoscopic access and dilatation of the tract to 20 mm...
May 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28100940/surgery-in-pancreatic-necrosis-challenges-and-outcomes-in-an-industrial-hospital
#19
Ashok Chattoraj, Sunil Kumar
Twenty-seven cases of pancreatic necrosis were admitted and treated at our hospital from Jan 2010 till Jan 2015. Eight of these patients (29 %) underwent pancreatic necrosectomy. Of a total number of 957 patients admitted for acute pancreatitis, 27 patients (3 %) were diagnosed to have necrotizing pancreatitis. Of the 8 patients operated on, 5 patients (62.5 %) were treated successfully. The 3 patients who died had 3 organ (renal, respiratory and cardiovascular) failures. Nineteen patients of pancreatic necrosis responded to medical management and were successfully treated...
December 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28032656/endoscopic-ultrasonography-guided-drainage-of-pancreatic-fluid-collections
#20
REVIEW
Tiing Leong Ang, Anthony Y B Teoh
Endoscopic ultrasound (EUS)-guided drainage is now firmly established as the best option for drainage of walled-off pancreatic fluid collections (PFC). It has high clinical efficacy, similar to surgical and percutaneous approaches, but with lower morbidity and costs. It is superior to non-EUS-guided approaches because even collections without endoluminal bulging can be successfully drained. Transmural drainage alone is sufficient for pseudocysts, but in the context of walled-off pancreatic necrosis (WON), adjunctive direct endoscopic necrosectomy (DEN) may be required...
May 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
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