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- W3201056500 abstract "Presenter: Janet W Li MD | Case Western Reserve University School of Medicine/MetroHealth Medical Center Background: Walled-off pancreatic necrosis (WOPN) is a known complication of acute pancreatitis. For patients who are symptomatic, the consensus guidelines have generally advocated for no intervention for 3-4 weeks so that a cyst wall may develop and then a step-up approach beginning with percutaneous drainage or repeated endoscopic transmural drainage using self-expanding metal stents. Herein, we report our one-stage management strategy of biliary pancreatitis with walled-off necrosis Methods: 46 year-old gentleman developed acute necrotizing pancreatitis secondary to gallstones. He recovered from this episode, but ultimately developed sequelae of walled-off pancreatic necrosis. After allowing for maturation of the cyst wall, a CT was obtained showing walled-off pancreatic necrosis. Results: The patient underwent a robotic-assisted cholecystectomy, transgastric pancreatic necrosectomy and transgastric cystogastrostomy. He recovered well and was discharged post-operative day one. On follow-up CT, the WOPN had resolved with only a small fluid collection in the pancreatic body. The patient’s symptoms also resolved. Conclusion: Multiple approaches have been described for patients with biliary pancreatitis with symptomatic walled-off pancreatic necrosis: endoscopic debridement with cystogastrostomy, percutaneous drainage, and surgical necrosectomy. In select patients with WOPN from biliary pancreatitis, performing a one-staged robotic-assisted cholecystectomy with trans-gastric necrosectomy with cysto-gastrostomy results in the most efficient care. Robotic-assisted cholecystectomy with trans-gastric cystogastrostomy and pancreatic necrosectomy is safe and feasible and should be added to the algorithm for these patients. Future research should focus on comparing outcomes of these varied approaches to determine best practice." @default.
- W3201056500 created "2021-09-27" @default.
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- W3201056500 date "2021-01-01" @default.
- W3201056500 modified "2023-09-27" @default.
- W3201056500 title "Minimally invasive one-stage management of biliary pancreatitis with walled-off necrosis" @default.
- W3201056500 doi "https://doi.org/10.1016/j.hpb.2021.06.300" @default.
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