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Pancreatic necrosectomy

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https://www.readbyqxmd.com/read/28100940/surgery-in-pancreatic-necrosis-challenges-and-outcomes-in-an-industrial-hospital
#1
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/eus-guided-drainage-of-pancreatic-fluid-collections
#2
REVIEW
Tiing Leong Ang, Anthony Yuen Bun 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...
December 29, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28009718/the-role-of-endoscopic-intervention-in-the-management-of-inflammatory-pancreatic-fluid-collections
#3
Vikrant Parihar, Paul F Ridgway, Kevin C Conlon, Matthew Huggett, Barbara M Ryan
Pancreatic fluid collections (PFCs) are a frequent complication of pancreatitis, or less commonly, pancreatic trauma or surgery. The revised Atlanta Classification categorizes PFCs as acute or chronic, with further subclassification of acute collections into acute peripancreatic collections and acute necrotic collections and of chronic fluid collections into pseudocysts and walled-off pancreatic necrosis. Acute PFCs are generally only subjected to an intervention when they are infected and not responding to antibiotics and are not managed endoscopically...
December 22, 2016: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27977545/endoscopic-ultrasound-guided-drainage-of-walled-off-necrosis-in-children-with-fully-covered-self-expanding-metal-stents
#4
Zaheer Nabi, Sundeep Lakhtakia, Jahangeer Basha, Radhika Chavan, Mohan Ramchandani, Rajesh Gupta, Rakesh Kalapala, Santosh Darisetty, Rupjyoti Talukdar, D Nageshwar Reddy
BACKGROUND AND OBJECTIVE: Endoscopic ultrasound (EUS) guided drainage with fully covered self-expanding metallic stents (FCSEMS) have been successfully used in adult patients. However, the utility of FCSEMS in children with walled off necrosis (WON) is unknown. The aim of present study was to evaluate the feasibility, safety and efficacy of EUS-drainage of WON using FCSEMS in children. METHODS: We retrospectively evaluated the data of children (≤18 years) who underwent EUS-drainage of walled off necrosis (WON) using FCSEMS at our institution...
December 13, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/27931029/selective-necrosectomy-for-infected-pancreatic-necrosis
#5
Ola Ahmed, Claire L Donohoe, Daragh B Murphy, Brian J Marsh, John Conneely, Gerry P McEntee
BACKGROUND: Until recently, a diagnosis of infected pancreatic necrosis (IPN) warranted necrosectomy, which was associated with high morbidity and mortality rates greater than 20%. Preoperative percutaneous drainage delayed the need for necrosectomy with improved outcomes. METHODS: In 2008, this institution changed its approach to the management of such cases opting instead for percutaneous drainage with selective deferred necrosectomy. A total of 38 consecutive patients with IPN from January 2008 to December 2014 were included...
December 9, 2016: Digestive Surgery
https://www.readbyqxmd.com/read/27908599/prospective-evaluation-of-a-new-biflanged-metal-stent-for-the-treatment-of-pancreatic-fluid-collections-with-videos
#6
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/27868439/-the-treatment-of-walled-off-pancreatic-necrosis-review
#7
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
#8
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
#9
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/27832819/negative-pressure-irrigation-and-endoscopic-necrosectomy-through-man-made-sinus-tract-in-infected-necrotizing-pancreatitis-a-technical-report
#10
Zhihui Tong, Lu Ke, Baiqiang Li, Gang Li, Jing Zhou, Xiao Shen, Weiqin Li, Ning Li, Jieshou Li
BACKGROUND: In recent years, a step-up approach based on minimally invasive techniques was recommended by latest guidelines as initial invasive treatment for infected pancreatic necrosis (IPN). In this study, we aimed to describe a novel step-up approach for treating IPN consisting of four steps including negative pressure irrigation (NPI) and endoscopic necrosectomy (ED) as a bridge between percutaneous catheter drainage (PCD) and open necrosectomy METHODS: A retrospective review of a prospectively collected internal database of patients with a diagnosis of IPN between Jan, 2012 to Dec, 2012 at a single institution was performed...
November 10, 2016: BMC Surgery
https://www.readbyqxmd.com/read/27806777/-clinical-experience-on-the-employment-of-the-staged-step-up-approach-in-the-treatment-of-local-complications-secondary-to-severe-acute-pancreatitis
#11
L Ji, B Sun, C D Cheng, X W Bai, G Wang, R Kong, H Chen, H C Jiang
Objective: To explore the experience and prognostic factors associated with the employment of the step-up approach in the treatment of local complications secondary to severe acute pancreatitis (SAP). Methods: The clinical data of 279 patients admitted to the Department of Pancreatic and Biliary Surgery, First Affiliated Hospital of Harbin Medical University from January 2011 to December 2015, whose local complications secondary to SAP were treated in a staged step-up framework, were retrospectively analyzed...
November 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal 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
#12
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
#13
EDITORIAL
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/27668746/open-surgical-versus-minimal-invasive-necrosectomy-of-the-pancreas-a-retrospective-multicenter-analysis-of-the-german-pancreatitis-study-group
#14
Sebastian Rasch, Veit Phillip, Stephanie Reichel, Bettina Rau, Christian Zapf, Jonas Rosendahl, Ulrich Halm, Markus Zachäus, Martin Müller, Alexander Kleger, Albrecht Neesse, Jochen Hampe, Mark Ellrichmann, Felix Rückert, Peter Strauß, Alexander Arlt, Volker Ellenrieder, Thomas M Gress, Werner Hartwig, Ernst Klar, Joachim Mössner, Stefan Post, Roland M Schmid, Thomas Seufferlein, Marco Siech, Jens Werner, Uwe Will, Hana Algül
BACKGROUND: Necrotising pancreatitis, and particularly infected necrosis, are still associated with high morbidity and mortality. Since 2011, a step-up approach with lower morbidity rates compared to initial open necrosectomy has been established. However, mortality and complication rates of this complex treatment are hardly studied thereafter. METHODS: The German Pancreatitis Study Group performed a multicenter, retrospective study including 220 patients with necrotising pancreatitis requiring intervention, treated at 10 hospitals in Germany between January 2008 and June 2014...
2016: PloS One
https://www.readbyqxmd.com/read/27665262/endoscopic-ultrasonography-guided-drainage-combined-with-trans-duodenoscope-cyclic-irrigation-technique-for-walled-off-pancreatic-necrosis
#15
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...
January 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/27651917/case-report-of-eus-guided-endoscopic-transduodenal-necrosectomy-in-a-patient-with-sleeve-gastrectomy
#16
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/27643484/a-low-impact-approach-to-infected-pancreatic-necrosis-review-of-a-case-series
#17
Amit Velagapudi, Matthew McKay, Tasmin Barry, Simon Bann, Susrutha K Wickremesekera
BACKGROUND: Infected pancreatic necrosis develops in approximately one third of patients with necrotizing pancreatitis and can lead to significant morbidity and mortality rates. Historically, open necrosectomy has been the mainstay of management for these patients but is in itself a morbid procedure. In recent times, minimally invasive techniques have evolved to allow a less invasive approach to these patients. Percutaneous catheter drainage of infected pancreatic necrosis is a technique that has been demonstrated to be potentially useful in the treatment of this group of patients...
December 2016: Surgical Infections
https://www.readbyqxmd.com/read/27525603/predictive-factors-of-failure-and-mortality-after-ct-guided-percutaneous-drainage-of-infected-pancreatic-necrosis
#18
Wejih Dougaz, Ibtissem Bouasker, Samia Ben Osman, Ramzi Nouira, Chadli Dziri
BACKGROUND: The traditional approach to the drainage of infected pancreatic necrosis (IPN) is open necrosectomy. As an alternative to open necrosectomy, percutaneous drainage is the first-line treatment of IPN. This study is aimed to identify predictive factor of failure after CT-guided percutaneous catheter drainage (PCD) of IPN. METHODS: Between June 1st 1988 and October 31th 2011, 26 patients with IPN were treated by PCD. The outcome measures were the failure of the PCD and/or death...
January 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/27522612/salvage-anastomosis-for-postoperative-chronic-pancreatic-fistula
#19
Shoji Kawakatsu, Yuji Kaneoka, Atsuyuki Maeda, Yasuyuki Fukami
Salvage anastomosis for postoperative chronic pancreatic fistula is challenging, and its safety and surgical outcomes remain unclear. Four patients with postoperative chronic pancreatic fistulas who underwent surgical interventions in our institute were retrospectively reviewed. A re-pancreatojejunostomy was performed in two patients with a disruption of the pancreatojejunostomy and a dilated main pancreatic duct of the remnant pancreas. A fistulojejunostomy was performed in the remaining two patients with a duct disruption after necrosectomy for necrotic severe acute pancreatitis and non-dilated main pancreatic duct...
December 2016: Updates in Surgery
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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