Retroperitoneal endoscopic debridement for infected peripancreatic necrosis

Seifert, H.; Wehrmann, T.; Schmitt, T.; Zeuzem, Stefan; Caspary, W. F.

doi:10.1016/s0140-6736(00)02611-8

Cited by 333 publications

(213 citation statements)

References 5 publications

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“…The video-assisted retroperitoneal approach involves the placement of laparoscopic equipment through posterior incisions, followed by the creation of a postoperative lavage system and carries the theoretical advantage of not violating the peritoneal cavity [46]. Recent literature is flourishing with case reports and small series describing the successful results of endoscopic and natural orifices surgical approaches [40,47,48,49]. Also noteworthy is the approach described by Bala and cols., in which a percutaneous drainage tract is constructed initially by CT-guided puncture of the necrosis, followed by the placement of a catheter and dilation of the tract, allowing subsequent percutaneous debridement of the necrosis [5].…”

Section: Role Of Surgery and Other Invasive Methods In Sapmentioning

confidence: 99%

Necrotizing Pancreatitis: Update and When to Operate

Refinetti¹,

Martinez²

2012

CMD

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About 20% of the cases of acute pancreatitis present in a severe form, known as necrotizing pancreatitis. Although this entity was first described centuries ago, many questions about it remain open and as a consequence, many studies are currently published addressing this subject nowadays. We performed a throughout research in the literature, with special attention to the articles published in the last five years and indexed to the PubMed. The following headings were used: Pancreatitis, Surgical procedures, Necrosis. The initial research rendered about 1800 articles, and the ones published in the last five years were evaluated. Some older, but remarkable articles were also included given their importance to this matter. As we further describe, treatment of acute pancreatitis involves a great number of questions, among which the most important are the ones related to the terminology of pancreatic collections, prognostic markers, use of antibiotics, type of diet employed and the approach to infected necrosis. Many radical changes could be seen over the last years on all these topics and a constant updating must be necessarily done by the ones involved in the treatment of this disease.

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Section: Role Of Surgery and Other Invasive Methods In Sapmentioning

confidence: 99%

Necrotizing Pancreatitis: Update and When to Operate

Refinetti¹,

Martinez²

2012

CMD

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“…(6,7) Infected WOPN are pancreatic collections that arise as a complication of severe necrotising pancreatitis, where liquefactive necrosis occurs, and in which a pseudo-capsule or wall subsequently develops. With the technique of DEN, a stoma is created endoscopically between the enteric lumen and the walled-off fluid collection to allow the insertion of an endoscope directly into the fluid collection, which allows endoscopic necrosectomy to be performed.…”

Section: Introductionmentioning

confidence: 99%

inShare Direct endoscopic necrosectomy: a minimally invasive endoscopic technique for the treatment of infected walled-off pancreatic necrosis and infected pseudocysts with solid debris

Kwek¹,

Tan²,

Ibrahim³

et al. 2013

SMedJ

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INTRODUCTION Endoscopic transenteric stenting is the standard treatment for pseudocysts, but it may be inadequate for treating infected collections with solid debris. Surgical necrosectomy results in significant morbidity. Direct endoscopic necrosectomy (DEN), a minimally invasive treatment, may be a viable option. This study examined the efficacy and safety of DEN for the treatment of infected walled-off pancreatic necrosis and infected pseudocysts with solid debris. METHODSThis study was a retrospective analysis of data collected from a prospective database of patients who underwent DEN in the presence of infected walled-off pancreatic necrosis or infected pseudocysts with solid debris from April 2007 to October 2011. DEN was performed as a staged procedure. Endoscopic ultrasonography-guided transgastric stenting was performed during the first session for initial drainage and to establish endoscopic access to the infected collection. In the second session, the drainage tract was dilated endoscopically to allow transgastric passage of an endoscope for endoscopic necrosectomy. Outcome data included technical success, clinical success and complication rates. RESULTSEight patients with infected walled-off pancreatic necrosis or infected pseudocysts with solid debris (mean size 12.5 cm; range 7.8-17.2 cm) underwent DEN. Underlying aetiologies included severe acute pancreatitis (n = 6) and post-pancreatic surgery (n = 2). DEN was technically successful in all patients. Clinical resolution was achieved in seven patients. One patient with recurrent collection opted for surgery instead of repeat endotherapy. No procedural complications were encountered.CONCLUSION DEN is a safe and effective minimally invasive treatment for infected walled-off pancreatic necrosis and infected pseudocysts.

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“…Durante muchos años la cirugía abierta ha sido realizada para establecer el diagnóstico o tratamiento en las enfermedades de los órganos intrabdominales [1][2][3][4] . Los objetivos de este artículo fueron realizar la revisión sistemática y crítica de la literatura publicada en el ámbito de la cirugía endoscópica a través de orificios naturales (NOTES) en la cirugía intrabdominal, evaluar los modelos, técnicas, resultados, errores y su posible aplicación en la práctica clínica.…”

Section: Introductionunclassified

“…Otros inconvenientes incluyen; lesiones de los órganos, abscesos intrabdominales, formación de adherencias (patología obstructiva), y las complicaciones que pueden derivarse del acto anestésico 3 . Las incisiones que se realizan en la laparoscopia son más pequeñas (micro laparotomías), por lo tanto, las tasas de complicaciones se reducen 4,5 . La recuperación es más rápida, hay descenso en los porcentajes de infecciones de las heridas y reducción del dolor postoperatorio [6][7][8][9] .…”

Section: Introductionunclassified

Cirugía endoscópica trans orificios naturales (NOTES)

O¹,

Useche

2009

Rev Chil Cir

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Systematic review of natural orifice transluminal endoscopy surgery (NOTES) for intrabdominal surgeryBackground: NOTES allows to perform entire traditional surgical procedures through a natural orifice. Aim: To evaluate models, techniques, outcomes, pitfalls, and applicability to the clinical setting of NOTES for intra abdominal surgery. Material and Methods: Systematic review of the literature. Studies were identified searching MEDLINE, EMBASE, CINAHL, Current Contents, Cochrane Library, Entrez PubMed, Clinical Trials Database from 2000 to 2008. Studies indentified in October 2008, were included if they were performed in live human subjects. Results: Of the studies included for review, most were experimental studies conducted in animals. Thus, the evidence base was very limited. Although intra-abdominal access could be achieved reliably via oral, anal, or urethral orifices, the optimal access route and method could not be established. Closure of viscerotomies could not be achieved reliably in all cases and the risk of peritoneal infection was not adequately evaluated. Although the majority of interventions could be performed in animals using NOTES, a number of technical problems were encountered that need to be resolved. Conclusions: NOTES is still in early stages of development and more robust technologies will be needed to achieve reliable closure and overcome technical challenges. Well-managed human studies need to be conducted to determine the safety and efficacy of NOTES in a clinical setting.

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Retroperitoneal endoscopic debridement for infected peripancreatic necrosis

Cited by 333 publications

References 5 publications

Necrotizing Pancreatitis: Update and When to Operate

Necrotizing Pancreatitis: Update and When to Operate

inShare Direct endoscopic necrosectomy: a minimally invasive endoscopic technique for the treatment of infected walled-off pancreatic necrosis and infected pseudocysts with solid debris

Cirugía endoscópica trans orificios naturales (NOTES)

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