Minimally Invasive Pancreatic Surgery: What the Future Holds for This Field?

Senthilnathan, Palanisamy; Gurumurthy, S. Srivatsan; Palanivelu, Chinnusamy

doi:10.1007/978-981-13-0161-2_6

Cited by 1 publication

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“…According to a previous study, if PP is not absorbed naturally or treated correctly, other complications, such as swollen bursa rupture and intracapsular hemorrhage, will occur which will aggravate the disease (16). At present, the continuous development of minimally invasive surgical techniques in clinical practice has diversified the surgical schemes for SAP complicated with PP (17). Duodenoscopy combined with laparoscopic surgery is a combined method during which a support frame is implanted between the cyst and the stomach of the patient under the guidance of endoscopy so that the cyst can enter the stomach more smoothly, making its removal much more convenient, and greatly reducing the pain after surgery (18).…”

Section: Discussionmentioning

confidence: 99%

Clinical efficacy of duodenoscopy combined with laparoscopy in the treatment of patients with severe acute pancreatitis and pancreatic pseudocyst, and the effects on IL‑6 and CRP

et al. 2020

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The study aimed to investigate the clinical efficacy of duodenoscopy combined with laparoscopy in the treatment of patients with severe acute pancreatitis (SAP) and pancreatic pseudocyst (PP), and its effects on serum inflammatory factors. Altogether 94 patients complicated with SAP and PP who were admitted to Weifang People's Hospital (Weifang, China) from September 2015 to December 2018 were included. Based on the different operation methods, 49 patients who underwent traditional laparotomy under laparoscopic surgery were included in group A, and 45 patients who underwent duodenoscopy and laparoscopy under duodenoscope to treat the drainage of nipple and pancreatic pseudocysts were included in group B. The expression levels of related serum indexes and serum stress indexes before and at 48 h after surgery, the postoperative nausea, vomiting and abdominal pain scores, as well as the clinical efficacy, perioperative related indexes, recovery and complications were compared between the two groups. The prognostic factors in both groups were assessed via Logistic univariate and multivariate analyses. C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-β (IL-β), endotoxin and nuclear factor κB (NF-κB) were significantly lower in group B than those in group A (P<0.001). Upregulating cortisol and norepinephrine in group B was lower than that in group A (P<0.001). The total effective rate in group B was higher than that in group A (P<0.05). The perioperative related indexes, recovery, and postoperative complications in group B were better than those in group A (P<0.05). Scores of abdominal pain, nausea and vomiting in group B were markedly lower than those in group A (P<0.001). Multivariate Logistic regression analysis showed that CRP, TNF-α, IL-6, IL-β and surgical methods were independent risk factors for the prognosis of patients with SAP and PP. In conclusion, the combined treatment with duodenoscopy and laparoscopic surgery has little inflammatory and stress reaction, and it is highly safe, worthy to be popularized.

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Section: Discussionmentioning

confidence: 99%