Percutaneous endoscopic necrosectomy of walled-off pancreatic and peripancreatic necrosis.
EAES Academy. Jagielski M. 07/05/22; 363072; P117
Prof. Dr. Mateusz Jagielski
Contributions
Contributions
Abstract
Aims:
In recent decades we observe constant development of minimally invasive techniques of treatment of consequences of acute necrotizing pancreatitis. The choice of access to the necrotic collection should mainly depend of localization of necrotic changes and experience of the medical center. Prospective assessment of efficiency and safety of innovative method of percutaneous necrosectomy in the treatment of patients with symptomatic walled-off pancreatic and peripancreatic necrosis.
Methods:
186 consecutive patients with symptomatic walled-off pancreatic and peripancreatic necrosis treated in the Department of General, Gastroenterological and Oncological Surgery, Collegium Medicum, Nicolaus Copernicus University in Toruń, Poland between 2018 and 2021 were included. The analyzed patients were treated with novel method of endoscopic percutaneous necrosectomy, in which percutaneous access to the necrotic collection was achieved with use of retroperitoneal route; consequently, the access was widened and self-expanding metal stent was placed percutaneously, which allowed to introduce the endoscope percutaneously into necrotic area and to perform endoscopic necrosectomy.
Results:
In 13/186 (6.99%) patients with symptomatic walled-off pancreatic and peripancreatic necrosis an additional percutaneous drainage was performed during the endotherapy. In 7/13 (53.85%) patients (2 females and 5 males; average age 46.72 [31-65] years) were qualified to percutaneous endoscopic necrosectomy. Average size of the necrotic collection was 24.88 (15.24-32.5) cm. An active percutaneous drainage during transmural endoscopic drainage lasted 15 (11-31) days. Average number of procedures of percutaneous endoscopic necrosectomy was 3.67 (2-7). Complications of treatment were stated in 2/7 (28.57%) patients. Clinical success was achieved in 6/7 (85.71%) patients. Log-term success was stated in 6/7 (85.71%) patients.
Conclusion:
Percutaneous endoscopic necrosectomy during transmural endoscopic drainage of walled-off pancreatic and peripancreatic necrosis is an effective method of minimally invasive treatment.
In recent decades we observe constant development of minimally invasive techniques of treatment of consequences of acute necrotizing pancreatitis. The choice of access to the necrotic collection should mainly depend of localization of necrotic changes and experience of the medical center. Prospective assessment of efficiency and safety of innovative method of percutaneous necrosectomy in the treatment of patients with symptomatic walled-off pancreatic and peripancreatic necrosis.
Methods:
186 consecutive patients with symptomatic walled-off pancreatic and peripancreatic necrosis treated in the Department of General, Gastroenterological and Oncological Surgery, Collegium Medicum, Nicolaus Copernicus University in Toruń, Poland between 2018 and 2021 were included. The analyzed patients were treated with novel method of endoscopic percutaneous necrosectomy, in which percutaneous access to the necrotic collection was achieved with use of retroperitoneal route; consequently, the access was widened and self-expanding metal stent was placed percutaneously, which allowed to introduce the endoscope percutaneously into necrotic area and to perform endoscopic necrosectomy.
Results:
In 13/186 (6.99%) patients with symptomatic walled-off pancreatic and peripancreatic necrosis an additional percutaneous drainage was performed during the endotherapy. In 7/13 (53.85%) patients (2 females and 5 males; average age 46.72 [31-65] years) were qualified to percutaneous endoscopic necrosectomy. Average size of the necrotic collection was 24.88 (15.24-32.5) cm. An active percutaneous drainage during transmural endoscopic drainage lasted 15 (11-31) days. Average number of procedures of percutaneous endoscopic necrosectomy was 3.67 (2-7). Complications of treatment were stated in 2/7 (28.57%) patients. Clinical success was achieved in 6/7 (85.71%) patients. Log-term success was stated in 6/7 (85.71%) patients.
Conclusion:
Percutaneous endoscopic necrosectomy during transmural endoscopic drainage of walled-off pancreatic and peripancreatic necrosis is an effective method of minimally invasive treatment.
Aims:
In recent decades we observe constant development of minimally invasive techniques of treatment of consequences of acute necrotizing pancreatitis. The choice of access to the necrotic collection should mainly depend of localization of necrotic changes and experience of the medical center. Prospective assessment of efficiency and safety of innovative method of percutaneous necrosectomy in the treatment of patients with symptomatic walled-off pancreatic and peripancreatic necrosis.
Methods:
186 consecutive patients with symptomatic walled-off pancreatic and peripancreatic necrosis treated in the Department of General, Gastroenterological and Oncological Surgery, Collegium Medicum, Nicolaus Copernicus University in Toruń, Poland between 2018 and 2021 were included. The analyzed patients were treated with novel method of endoscopic percutaneous necrosectomy, in which percutaneous access to the necrotic collection was achieved with use of retroperitoneal route; consequently, the access was widened and self-expanding metal stent was placed percutaneously, which allowed to introduce the endoscope percutaneously into necrotic area and to perform endoscopic necrosectomy.
Results:
In 13/186 (6.99%) patients with symptomatic walled-off pancreatic and peripancreatic necrosis an additional percutaneous drainage was performed during the endotherapy. In 7/13 (53.85%) patients (2 females and 5 males; average age 46.72 [31-65] years) were qualified to percutaneous endoscopic necrosectomy. Average size of the necrotic collection was 24.88 (15.24-32.5) cm. An active percutaneous drainage during transmural endoscopic drainage lasted 15 (11-31) days. Average number of procedures of percutaneous endoscopic necrosectomy was 3.67 (2-7). Complications of treatment were stated in 2/7 (28.57%) patients. Clinical success was achieved in 6/7 (85.71%) patients. Log-term success was stated in 6/7 (85.71%) patients.
Conclusion:
Percutaneous endoscopic necrosectomy during transmural endoscopic drainage of walled-off pancreatic and peripancreatic necrosis is an effective method of minimally invasive treatment.
In recent decades we observe constant development of minimally invasive techniques of treatment of consequences of acute necrotizing pancreatitis. The choice of access to the necrotic collection should mainly depend of localization of necrotic changes and experience of the medical center. Prospective assessment of efficiency and safety of innovative method of percutaneous necrosectomy in the treatment of patients with symptomatic walled-off pancreatic and peripancreatic necrosis.
Methods:
186 consecutive patients with symptomatic walled-off pancreatic and peripancreatic necrosis treated in the Department of General, Gastroenterological and Oncological Surgery, Collegium Medicum, Nicolaus Copernicus University in Toruń, Poland between 2018 and 2021 were included. The analyzed patients were treated with novel method of endoscopic percutaneous necrosectomy, in which percutaneous access to the necrotic collection was achieved with use of retroperitoneal route; consequently, the access was widened and self-expanding metal stent was placed percutaneously, which allowed to introduce the endoscope percutaneously into necrotic area and to perform endoscopic necrosectomy.
Results:
In 13/186 (6.99%) patients with symptomatic walled-off pancreatic and peripancreatic necrosis an additional percutaneous drainage was performed during the endotherapy. In 7/13 (53.85%) patients (2 females and 5 males; average age 46.72 [31-65] years) were qualified to percutaneous endoscopic necrosectomy. Average size of the necrotic collection was 24.88 (15.24-32.5) cm. An active percutaneous drainage during transmural endoscopic drainage lasted 15 (11-31) days. Average number of procedures of percutaneous endoscopic necrosectomy was 3.67 (2-7). Complications of treatment were stated in 2/7 (28.57%) patients. Clinical success was achieved in 6/7 (85.71%) patients. Log-term success was stated in 6/7 (85.71%) patients.
Conclusion:
Percutaneous endoscopic necrosectomy during transmural endoscopic drainage of walled-off pancreatic and peripancreatic necrosis is an effective method of minimally invasive treatment.
{{ help_message }}
{{filter}}