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01-07-2011 | 2010 SSAT State of the Art Conference

Endoscopic Pancreatic Necrosectomy

Author: Evan L. Fogel

Published in: Journal of Gastrointestinal Surgery | Issue 7/2011

Abstract

Traditionally, patients with symptomatic sterile pancreatic necrosis or infected necrosis have been managed by open surgical debridement and removal of necrotic tissue. Within the last decade, however, reports of endoscopic pancreatic necrosectomy, an alternative minimally invasive approach, have demonstrated high success rates and low mortality rates. This report describes the indications, technique, and study outcome data of the procedure. While our experience with this technique has recently increased, better selection criteria are needed to identify patients who are most suitable for endoscopic therapy.

Navaneethan U, Vege SS, Chari ST, et al. Minimally invasive techniques in pancreatic necrosis (review). Pancreas 2009;38:867–75.PubMedCrossRef

Uhl W, Warshaw A, Imrie C, et al. IAP guidelines for the surgical management of acute pancreatitis. Pancreatology 2002;2:565–73.PubMedCrossRef

Besselink MGH, Verwer TJ, Schoenmaeckers EJ, et al. Timing of surgical intervention in necrotizing pancreatitis. Arch Surg 2007;142:1194–201.PubMedCrossRef

Papachristou GI, Takahashi N, Chahal P, et al. Peroral endoscopic drainage/debridement of walled-off pancreatic necrosis. Ann Surg 2007;245:943–51.PubMedCrossRef

Baron TH, Thaggard WG, Morgan DE, et al. Endoscopic therapy for organized pancreatic necrosis. Gastroenterology 1996;111:755–64.PubMedCrossRef

Hariri M, Slivka A, Carr-Locke DL, et al. Pseudocyst drainage predisposes to infection when pancreatic necrosis is unrecognized. Am J Gastroenterol 1994;89:1781–4.PubMed

Kozarek RA. Endoscopic management of pancreatic necrosis: not for the uncommitted. Gastrointest Endosc 2005;62:101–4.PubMedCrossRef

Adkinson K, Morgan D, Baron TH. Long term outcome following successful endoscopic drainage of organized pancreatic necrosis. Gastrointest Endosc 1997;45:514.

Seifert H, Wehrmann T, Schmitt T, et al. Retroperitoneal endoscopic debridement for infected peripancreatic necrosis. Lancet 2000;356:653–5.PubMedCrossRef

10.

Baron T, Morgan D. Endoscopic transgastric irrigation tube placement via PEG for debridement of organized pancreatic necrosis. Gastrointest Endosc 1999;50:574–7.PubMedCrossRef

11.

Charnley RM, Lochan R, Gray H, et al. Endoscopic necrosectomy as primary therapy in the management of infected pancreatic necrosis. Endoscopy 2006;38:925–8.PubMedCrossRef

12.

Voermans RP, Veldkamp MC, Rauws EA, et al. Endoscopic transmural debridement of symptomatic organized pancreatic necrosis (with videos). Gastrointest Endosc 2007;66:909–16.PubMedCrossRef

13.

Navaneethan U, Al Mohajer M, Schmulewitz N, et al. Endoscopic necrosectomy in the management of walled of pancreatic necrosis. Am J Gastroenterol 2008;103(suppl 1):S514-5.

14.

Mathew A, Biswas A, Meitz KP. Endoscopic necrosectomy as primary treatment for infected peripancreatic fluid collections (with video). Gastrointest Endosc 2008;68:776–82.PubMedCrossRef

15.

Gardner TB, Chahal P, Papachristou GI, et al. A comparison of direct endoscopic necrosectomy with transmural endoscopic drainage for the treatment of walled-off pancreatic necrosis. Gastrointest Endosc 2009;69:1085–94.PubMedCrossRef

16.

Seifert H, Biermer M, Schmitt W, et al. Transluminal endoscopic necrosectomy after acute pancreatitis: a multicenter study with long-term follow-up (the GEPARD Study). Gut 2009;58:1260–6.PubMedCrossRef

17.

Barthet M, Ezzedine S. Transluminal endoscopic necrosectomy for pancreatic necrosis: in all hands and for all patients, or with selected endoscopists in selected patients? Gut 2009;58:1180–2.PubMedCrossRef

18.

Kahaleh M, Shami VM, Conaway MR, et al. Endoscopic ultrasound drainage of pancreatic pseudocyst: a prospective comparison with conventional endoscopic drainage. Endoscopy 2006;38:355–9.PubMedCrossRef

19.

Seewald S, Groth S, Omar S, et al. Aggressive endoscopic therapy for pancreatic necrosis and pancreatic abscess: a new safe and effective treatment algorithm (videos). Gastrointest Endosc 2005;62:92–100.PubMedCrossRef

20.

Seifert H, Schuette A, Troschel P, et al. Transgastric endoscopic retroperitoneal debridement of peripancreatic necrosis in 50 patients. Gastrointest Endosc 2007;65:AB206.CrossRef

Title: Endoscopic Pancreatic Necrosectomy
Author: Evan L. Fogel
Publication date: 01-07-2011
Publisher: Springer-Verlag
Published in: Journal of Gastrointestinal Surgery / Issue 7/2011
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-011-1505-y

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