Is irrigation necessary during endoscopic necrosectomy of pancreatic necroses?

Zerem, Enver; Imamović, Goran; Mavija, Zoran

doi:10.1007/s00464-012-2257-9

Surg Endosc

2012

DOI: 10.1007/s00464-012-2257-9

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Is irrigation necessary during endoscopic necrosectomy of pancreatic necroses?

Enver Zerem

Goran Imamović

Zoran Mavija

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“…With interest we read the letter by Zerem and Mavija [1] regarding our article on endoscopic management of necrotizing pancreatitis [2]. The authors described their experience with percutaneous drainage as a management modality for necrotizing pancreatitis [3].…”

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confidence: 99%

Reply to: doi:10.1007/s00464-012-2257-9: Endoscopic ultrasound-guided endoscopic necrosectomy of the pancreas: is irrigation necessary?

Jürgensen

2012

Surg Endosc

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confidence: 99%

Reply to: doi:10.1007/s00464-012-2257-9: Endoscopic ultrasound-guided endoscopic necrosectomy of the pancreas: is irrigation necessary?

Jürgensen

2012

Surg Endosc

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Comments on the article about the treatment of infected pancreatic necrosis

Zerem

Omerović

2013

Surg Endosc

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Treatment of severe acute pancreatitis and its complications

Zerem

2014

WJG

264

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Severe acute pancreatitis (SAP), which is the most serious type of this disorder, is associated with high morbidity and mortality. SAP runs a biphasic course. During the first 1-2 wk, a pro-inflammatory response results in systemic inflammatory response syndrome (SIRS). If the SIRS is severe, it can lead to early multisystem organ failure (MOF). After the first 1-2 wk, a transition from a pro-inflammatory response to an anti-inflammatory response occurs; during this transition, the patient is at risk for intestinal flora translocation and the development of secondary infection of the necrotic tissue, which can result in sepsis and late MOF. Many recommendations have been made regarding SAP management and its complications. However, despite the reduction in overall mortality in the last decade, SAP is still associated with high mortality. In the majority of cases, sterile necrosis should be managed conservatively, whereas in infected necrotizing pancreatitis, the infected non-vital solid tissue should be removed to control the sepsis. Intervention should be delayed for as long as possible to allow better demarcation and liquefaction of the necrosis. Currently, the step-up approach (delay, drain, and debride) may be considered as the reference standard intervention for this disorder.

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Is irrigation necessary during endoscopic necrosectomy of pancreatic necroses?

Cited by 3 publications

References 6 publications

Reply to: doi:10.1007/s00464-012-2257-9: Endoscopic ultrasound-guided endoscopic necrosectomy of the pancreas: is irrigation necessary?

Reply to: doi:10.1007/s00464-012-2257-9: Endoscopic ultrasound-guided endoscopic necrosectomy of the pancreas: is irrigation necessary?

Comments on the article about the treatment of infected pancreatic necrosis

Treatment of severe acute pancreatitis and its complications

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