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- W3211283586 abstract "Background: A walled-off necrosis (WON) is a complication of acute pancreatitis and consists of an encapsulated collection of fluid and necrotic tissue. Usually requires intervention to treat obstructive or constitutional symptoms as well as possible infection. Minimally invasive surgical approach of WON allows drainage and debridement similar to open approach. Robotic surgery has some advantages in terms of hand-sewn anastomosis are possible to the stomach or duodenum, even in difficult anatomic locations of WON, such paracolic gutter or inframesocolic extension. Methods: A 22 years-old female who presented with a severe necrotizing acute biliary pancreatitis complicated with an acute peripancreatic fluid collection. Initial management consisted of medical therapy and an ultrasound-guided drainage of the collection, with a subsequent laparoscopic cholecystectomy. A year later the patient continued with recurrent abdominal pain and a food-intake intolerance. A 5x10,5cm walled-off necrosis was found in the pancreatic MRI associated with a disconnected duct syndrome. After a multidisciplinary committee, the surgical approach was chosen. A robotic-assisted Roux-En-Y cystojejunostomy and debridement of walled-off pancreatic necrosis was performed. The location of the pseudocyst was identified by transmesocolic needle aspiration. Pancreatic necrotic tissue was debrided and fluid aspirated. The cysto-jejunal anastomosis was hand-sewn using barbed suture and the jejuno-jejunal anastomosis was mechanical using a 45mm robotic endostapler. The operative time was 240 minutes and with estimated blood loss of 200 mL. Results: Postoperative outcomes were uneventful and the patient was discharged on postoperative day 4. Conclusion: The robotic approach is a safe technique that should be considered in the surgical treatment of the WON." @default.
- W3211283586 created "2021-11-08" @default.
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- W3211283586 date "2021-01-01" @default.
- W3211283586 modified "2023-10-17" @default.
- W3211283586 title "Robotic-assisted Roux-en-Y cystojejunostomy and debridement of walled-off pancreatic necrosis" @default.
- W3211283586 doi "https://doi.org/10.1016/j.hpb.2021.08.761" @default.
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