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- W2894883622 abstract "Introduction: Severe acute pancreatitis complicated by infected necrotizing pancreatitis is associated with significant morbidity and mortality. Modern surgery in patients with necrotizing pancreatitis consists of open-surgery and minimally invasive approaches: percutaneous drain placement, VARD, endoscopic transluminal necrosectomy. Materials and methods: Throughout 2011-2017 Botkin Clinical hospital admitted 246 patients with infected necrotizing pancreatitis for surgical treatment. The method's choice was made considering results of clinical examination, localization of acute collectors and necrotized tissues. Endosonography helps to evaluate chances for endoscopic drainage placement, visualize acute liquid collectors, earlier found on CT, determine the type of acute collectors, evaluate length of necrotizing tissues. 12 mm Self-expanding metal stents were placed and direct necrosectomy was performed. Results: In 14 cases we used endoscopic transluminal necrosectomy (patients with diagnosed «walled-off necrosis» and acute collectors). 8 Patients were completely cured only by this method and without any further need for open surgery. In 6 patients we added adjunctive percutaneous drains for better irrigation and debridement. The transluminal necrosectomy was repeated 2-7 times in case of no clinical improvement or if necrotized tissues couldn't be fully removed. The average frequency of procedures was 3.6. One complication occurred (arrosive bleeding which was stopped by endoscopic hemostasis). There was no mortality in this patients. Conclusion: Endoscopic transluminal necrosectomy is an effective minimally invasive method of debridement in patients with infected necrotizing pancreatitis with walled-off necrosis (especially if acute collectors and necrotized tissues located in the center of pancreas and peripancreatic space)." @default.
- W2894883622 created "2018-10-12" @default.
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- W2894883622 date "2018-09-01" @default.
- W2894883622 modified "2023-09-27" @default.
- W2894883622 title "Clinical experience of endoscopic transluminal pancreatic necrosectomy performed in cases of infected necrotizing pancreatitis at the stage of sequestration" @default.
- W2894883622 doi "https://doi.org/10.1016/j.hpb.2018.06.1893" @default.
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