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Surgical Endoscopy
Published in: Surgical Endoscopy 12/2011

01-12-2011 | Review

Endoscopic necrosectomy of pancreatic necrosis: a systematic review

Authors: Alireza Haghshenasskashani, Jerome M. Laurence, Vu Kwan, Emma Johnston, Michael J. Hollands, Arthur J. Richardson, Henry C. C. Pleass, Vincent W. T. Lam

Published in: Surgical Endoscopy | Issue 12/2011

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Abstract

Aim

To review the current status of the novel technique of endoscopic necrosectomy in the management of pancreatic necrosis after acute pancreatitis.

Methods

Studies were identified by searching Medline, PubMed and Embase databases for articles from January 1990 to December 2009 using the keywords “acute pancreatitis”, “pancreatic necrosis” and “endoscopy”. Additional papers were identified by a manual search of the references from the key articles. Case series of fewer than five patients and case reports were excluded.

Results

Indications, techniques and outcomes of endoscopic necrosectomy were analysed. There were no randomised controlled trials identified. Ten case series were included in this analysis. There were a total of more than 1,100 endoscopic necrosectomy procedures in 260 patients with pancreatic necrosis. One hundred fifty-five were proven to be infected necrosis on culture. The overall mortality rate was 5%. The mean procedure-related morbidity rate was 27%. The rate of complete resolution of pancreatic necrosis with the endoscopic method alone was 76%.

Conclusions

Endoscopic necrosectomy is a safe and effective treatment option in selected patients with pancreatic necrosis after acute pancreatitis. Future studies will be required to further define the selection criteria and the techniques for the endoscopic procedure.
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Metadata
Title
Endoscopic necrosectomy of pancreatic necrosis: a systematic review
Authors
Alireza Haghshenasskashani
Jerome M. Laurence
Vu Kwan
Emma Johnston
Michael J. Hollands
Arthur J. Richardson
Henry C. C. Pleass
Vincent W. T. Lam
Publication date
01-12-2011
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 12/2011
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-011-1795-x

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