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Pancreatic necrosectomy

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https://www.readbyqxmd.com/read/29663019/-retrieval-of-a-migrated-plastic-stent-in-a-51-year-old-man
#1
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/29644032/severe-acute-gallstone-pancreatitis-with-diffuse-hemorrhagic-gastritis
#2
Timothy J Harris, William C Beck, Avi Bhavaraju, Benjamin Davis, Mary K Kimbrough, Joseph C Jensen, Anna Privratsky, John R Taylor, Kevin W Sexton
A 67-year-old male presented with acute pancreatitis secondary to gallstones, also known as acute biliary pancreatitis, and subsequently developed gastric outlet obstruction and was transferred to our hospital. A gastro-jejunal feeding tube was placed and an open cholecystectomy was performed. The patient had a pancreatic drain placed for interval increase in pancreatic necrosis and then nearly exsanguinated from gastroduodenal artery pseudoaneurysm bleed. This was managed by coiling the gastroduodenal artery...
March 2018: Journal of Surgical Case Reports
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
#3
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/29541568/triple-pancreatic-walled-off-fluid-collections-treated-simultaneously-with-endoscopic-transmural-drainage
#4
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/29517639/risk-factors-for-the-need-of-surgical-necrosectomy-after-percutaneous-catheter-drainage-in-the-management-of-infection-secondary-to-necrotizing-pancreatitis
#5
Liang Ji, Gang Wang, Le Li, Yi-Long Li, Ji-Sheng Hu, Guang-Quan Zhang, Hong-Ze Chen, Hua Chen, Rui Kong, Xue-Wei Bai, Bei Sun
OBJECTIVES: This study aimed to assess the need of surgical necrosectomy after percutaneous catheter drainage (PCD) for infected necrotizing pancreatitis. METHODS: The clinical data of documented/suspected patients who were treated with a step-up approach were extracted and analyzed. RESULTS: Of the 329 patients enrolled, the initial PCD was performed at 12 (interquartile range, 9-15) days since onset and 35.3% were cured by PCD alone. In the pre-PCD model, mean computed tomographic (CT) density of necrotic fluid collection (NFC; P < 0...
April 2018: Pancreas
https://www.readbyqxmd.com/read/29517633/potential-prediction-of-acute-biliary-pancreatitis-outcome-on-admission
#6
Angeliki Papapanagiotou, George Sgourakis, Stella Peristeraki, Dimitris Raptis, Kyriakos Karkoulias, Stergios Tezas, Panna Patel, Athanasios G Papavassiliou
OBJECTIVES: This pilot study aimed to determine the feasibility of serum values of osteonectin, adiponectin, transforming growth factor beta 1, and neurotensin being used in clinical practice to predict the severity of acute pancreatitis. METHODS: Blood samples were collected from 45 consecutive newly diagnosed acute pancreatitis patients and 30 matched healthy controls. The 2 groups were matched according to age, sex, weight, height, diabetes, smoking, and alcohol consumption...
April 2018: Pancreas
https://www.readbyqxmd.com/read/29497687/endoscopic-necrosectomy-of-walled-off-pancreatic-necrosis-by-large-bore-percutaneus-metal-stent-a-new-opportunity
#7
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/29451168/percutaneous-catheter-drainage-followed-by-endoscopic-transluminal-drainage-necrosectomy-for-treatment-of-infected-pancreatic-necrosis-in-early-phase-of-illness
#8
Surinder Singh Rana, Rajesh Gupta, Mandeep Kang, Vishal Sharma, Ravi Sharma, Ujjwal Gorsi, Deepak K Bhasin
Background and Objectives: Infected pancreatic necrosis (IPN) in the early phase is treated with "step up approach" involving initial percutaneous catheter drainage (PCD) followed by necrosectomy. There is a paucity of data on a combined approach of initial PCD followed by endoscopic drainage and necrosectomy. A retrospectively study on safety and efficacy of initial PCD followed by endoscopic transluminal drainage and necrosectomy in IPN. Methods: Retrospective analysis of data of 23 patients with IPN who were treated with a combined approach...
January 2018: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/29409791/minimally-invasive-surgery-in-the-era-of-step-up-approach-for-treatment-of-severe-acute-pancreatitis
#9
Olga Morató, Ignasi Poves, Lucas Ilzarbe, Aleksandar Radosevic, Antonia Vázquez-Sánchez, Juan Sánchez-Parrilla, Fernando Burdío, Luís Grande
OBJECTIVES: To assess the minimally invasive surgery into the step-up approach procedures as a standard treatment for severe acute pancreatitis and comparing its results with those obtained by classical management. METHODS: Retrospective cohort study comparative with two groups treated over two consecutive, equal periods of time were defined: group A, classic management with open necrosectomy from January 2006 to June 2010; and group B, management with the step-up approach with minimally invasive surgery from July 2010 to December 2014...
January 30, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29390292/fatal-cerebral-hemorrhage-associated-with-acute-pancreatitis-a-case-report
#10
Xin Zhong, Shu Gong
RATIONALE: Pancreatic encephalopathy (PE) refers to the abnormalities in mental status that complicate acute pancreatitis (AP). We report the case of a patient who developed AP that was complicated by PE and followed by fatal cerebral hemorrhage. PATIENT CONCERNS: A 41-year-old male patient with AP that initially manifested with PE and was subsequently complicated by fatal cerebral hemorrhage. DIAGNOSES: A head computed tomography (CT) scan showed a fatal intracerebral hemorrhage located in the occipital lobe, and an abdominal CT scan presented a large amount of peripancreatic fluid collections...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29387710/pancreatic-fluid-collections-and-necrosectomy-with-plastic-stents-versus-lumen-apposing-stents
#11
Monica Saumoy, Marianna Arvanitakis, Michel Kahaleh
No abstract text is available yet for this article.
December 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/29383496/candidemia-after-endoscopic-therapy-with-lumen-apposing-metal-stent-for-pancreatic-walled-off-necrosis
#12
Tajana Pavic, Davor Hrabar, Dominik Kralj, Ivan Lerotic, Doris Ogresta
Necrotizing pancreatitis remains a challenging and unpredictable condition accompanied by various complications. Endoscopic ultrasound-guided transmural drainage and necrosectomy have become the standard treatment for patients with walled-off necrosis (WON). Endoscopic therapy via lumen-apposing metal stents (LAMS) with large diameters has shown success in the management of pancreatic fluid collections, but there are few data on specific complications of that therapy. We report a case of infected WON and concomitant fungemia following LAMS placement and necrosectomy...
January 30, 2018: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29310378/isolated-cerebral-aspergillosis-in-an-immunocompetent-woman-on-treatment-for-bacterial-infected-necrotizing-pancreatitis-a-case-report
#13
Shaoyang Zhang, Qinghui Fu, Qi Chen, Ting-Bo Liang
RATIONALE: Cerebral aspergillosis (CA) is a rare manifestation of invasive aspergillosis. It usually affects seriously immunocompromised hosts. Pancreatic bacterial or/and fungal infection is common in patients with severe acute pancreatitis. PATIENT CONCERNS: We report the first case of an immunocompetent woman with infected necrotizing pancreatitis due to multidrug resistant Acinetobacter baumannii who, in the course of treatment, developed isolated CA. DIAGNOSES: Magnetic resonance imaging, rather than computed tomography, revealed latent homolateral sinus disease-the possible source of the Aspergillus infection...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29301065/pancreatic-necrosectomy-through-sinus-tract-endoscopy
#14
Mahesh Kumar Goenka, Usha Goenka, Md Yasin Mujoo, Indrajit Kumar Tiwary, Sanjay Mahawar, Vijay Kumar Rai
Background/Aims: Direct endoscopic pancreatic necrosectomy is increasingly being utilized to treat infected or symptomatic walled-off necrosis (WON) located close to the stomach or duodenum. Laterally-placed WON has traditionally been treated surgically. We evaluated a less utilized technique of sinus tract endoscopy (STE) for symptomatic laterally-placed WON. Methods: Two hundred seventy-six patients with acute pancreatitis admitted in our hospital, 32 had symptomatic or infected WON requiring intervention...
January 4, 2018: Clinical Endoscopy
https://www.readbyqxmd.com/read/29251273/a-retrospective-study-evaluating-endoscopic-ultrasound-guided-drainage-of-pancreatic-fluid-collections-using-a-novel-lumen-apposing-metal-stent-on-an-electrocautery-enhanced-delivery-system
#15
Douglas G Adler, Linda Jo Taylor, Raza Hasan, Ali A Siddiqui
OBJECTIVES: To report the safety and clinical efficacy with the novel lumen-apposing metal stent (LAMS) with an electrocautery enhanced delivery system for the drainage of pancreatic fluid collections (PFCs). METHODS: This was a retrospective analysis of all consecutive patients with PFCs who underwent endoscopic ultrasound (EUS)-guided drainage using the LAMS with an electrocautery enhanced delivery system in 2 US centers. RESULTS: Thirteen patients with PFCs (69% with walled-off necrosis [WON]) underwent drainage using the study device...
November 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/29233670/safety-and-efficacy-of-lumen-apposing-metal-stents-with-and-without-simultaneous-double-pigtail-plastic-stents-for-draining-pancreatic-pseudocyst
#16
Murad Aburajab, Zachary Smith, Abdul Khan, Kulwinder Dua
BACKGROUND AND AIMS: Lumen-apposing metal stents (LAMSs) are used to perform necrosectomy in walled-off necrosis (WON). Although necrosectomy is not required for pancreatic pseudocyst (PP), an increasing number of PPs are also being drained with LAMSs in view of their ease of deployment. The aim of the present study was to evaluate the safety and efficacy of using LAMSs to drain PPs. METHODS: At 1 tertiary center from January 2014 to May 2016, all consecutive patients with PPs were drained by LAMSs, and the data were retrospectively reviewed...
December 9, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29221438/double-catheter-lavage-combined-with-percutaneous-flexible-endoscopic-debridement-for-infected-pancreatic-necrosis-failed-to-percutaneous-catheter-drainage
#17
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
#18
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
#19
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
#20
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
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