Minimally invasive endoscopic treatment of necrotizing pancreatitis: A case report with images and review of the literature

Moura, Cassia Lemos; Barros, Priscila Pulita Azevedo; Oliveira, Cristiane Mota; Colaiácovo, Rogério; Drigo, Juliana Marques; Carbonari, Augusto; Campos, Tércio De; Rossini, Lucio G.

doi:10.1590/1806-9282.63.03.207

Cited by 3 publications

(2 citation statements)

References 6 publications

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“…Acute Pancreatitis (AP) is a very frequent and potentially lethal condition, with more than 200,000 hospital admissions per year in the United States and an incidence of 4 to 45 per 100,000 patients per year in Europe [1,2]. Acute pancreatitis may lead to organ failures lasting more than 48 hours in roughly 20% to 25% of these individuals [3,4]. Even with severe acute pancreatitis, around 10%-20% of patients develop necrosis in one or both of the pancreas' parenchyma or the peripancreatic tissues around it, leading to acute necrotizing pancreatitis (ANP) [4,5].…”

Section: Introductionmentioning

confidence: 99%

“…Acute pancreatitis may lead to organ failures lasting more than 48 hours in roughly 20% to 25% of these individuals [3,4]. Even with severe acute pancreatitis, around 10%-20% of patients develop necrosis in one or both of the pancreas' parenchyma or the peripancreatic tissues around it, leading to acute necrotizing pancreatitis (ANP) [4,5]. When this necrotic tissue becomes infected, as occurs in 40-70% of ANP patients, the death rate might rise to 35-40%, as shown by current research on the subject.…”

Section: Introductionmentioning

confidence: 99%

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Patients' Prognosis in a Pakistani Hepato-Biliary Unit Treating Acute Severe Necrotizing Pancreatitis

Faisal¹,

Imranullah²,

Noshad³

et al. 2022

PJMHS

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Objective: The outcomes of individuals who were admitted to a hepatobiliary unit suffering from acute severe necrotizing pancreatitis will be the focus of this research. Study Design: Observational/ Prospective study Place and Duration: Conducted at Department of Gastroenterology Hayatabad Medical Complex Peshawar, during from the period Jan, 2021 to June, 2021. Methods: There were 85 patients of both genders were presented in this study. Included patients were aged between 20-70 years. All the patients had severe necrotizing pancreatitis were included. Detailed demographics of enrolled cases included age,sex, body mass index, etiology and comorbidities were recorded after taking informed written consent. Outcomes were calculated in terms of complications, hospital stay, number of drains inserted and nutritional support among all cases. SPSS 22.0 was used to analyze all data. Results: Among 85 patients, majority of the cases were males 62 (72.9%) and the rest of the patients were females 23 (27.1%). Included patients had mean age 47.12±8.39 years and had mean BMI 26.2±6.25 kg/m2. Most common comorbidity was diabetes mellitus found in 18 (21.2%),followed by hypertension in 17 (20%) and ischemic heart disease in 9 (10.6%) cases. Gall stones were the most common etiology found in 35 (41.2%) followed by idiopathic in 16 (18.8%) and cigarette smoking in 13 (15.3%) patients. NG feed was the most common nutrition in 19 (22.4%) cases. 10 was the most common CTSI score in 43 (50.6%) cases. Mean hospital stay was 31.9±11.82 days and infected necrosis / peri-pancreatic collections was the most common complication.13 (15.3%) cases received EUS drainage and surgical necrosectomy was given to 8 (9.4%) cases. Frequency of deaths was 10 (11.8%). Conclusion: A specialized hepato-biliary unit with a multidisciplinary team approach improves survival with acute severe necrotizing pancreatitis. Percutaneous and EUS-guided draining of pancreatic collections helps prevent necrosectomy for infected pancreatic necrosis. Keywords: Disease outcome, Acute pancreatitis, Infected pancreatic necrosis, Necrosectomy Acute Necrotizing Pancreatitis

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Patients' Prognosis in a Pakistani Hepato-Biliary Unit Treating Acute Severe Necrotizing Pancreatitis

Faisal¹,

Imranullah²,

Noshad³

et al. 2022

PJMHS

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Acute necrotizing pancreatitis: Has conservative management replaced surgery? Perspective from a tertiary care centre in Pakistan: A cross-sectional study

Mannan

Gill

Sohail

et al. 2021

Annals of Medicine &Amp; Surgery

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Background The main purpose of this study was to review the trends in management of patients presenting with acute necrotizing pancreatitis (ANP) over the last seven years and its effect on morbidity and mortality. Methods A cross-sectional study was conducted on all patients presenting with the diagnosis of acute necrotizing pancreatitis to the Aga Khan University Hospital in between the year 2008–2015. The study population was broadly categorized in to two groups based on the way these were managed. The first group consisted of patient who underwent surgery for acute necrotizing pancreatitis while the second group was composed of those patients with necrotizing pancreatitis who were conservatively managed. Patient outcomes were assessed in terms of hospital stay, complication rates and in-hospital mortality. Data was analyzed using SPSS version 20. Comparison of outcomes between two groups was done using chi-square test, Fischer exact test or t -test wherever applicable. A p-value of less than 0.05 was considered statistically significant. Results A total of n = 110 patients were included in the study with 68% (n = 75) males and 32% (n = 35) females. Nasojejunal route was found to be the most commonly utilized route of feeding in these patients consisting of around 49% (n = 54) patients with forty percent (n = 44) tolerating direct oral diet. The outcomes in both these groups in terms of hospital stay, complication rate, and in hospital mortality were not found to be statistically significant. The conservative group however was significant in terms of cost-effectiveness which was shown by a p value of (0.035). The management of this clinically important disease over the years showed an increased trend towards conservative approach in our institute. Conclusion Our study further substantiates the recent global trend of conservative approach towards managing patients with acute necrotizing pancreatitis as reflected in the recent available literature. Therefore surgeons of the developing world need to evolve and adapt to these new measures for better outcomes in patient management.

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Surgical Tactics for Hemorrhagic Complications of Pancreonecrosis

Boyko,

Merkulov,

Shevchenko

et al. 2023

Khark. Surg. Sch.

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Summary. The aim. of the study: to improve the results of surgical treatment of patients with erosive bleeding in pancreatic necrosis by using active surgical tactics with ligation of erosive arteries and semi-open methods of drainage. The results of surgical treatment of 85 patients with erosive bleeding in pancreatic necrosis are presented. In 22 cases, erosive bleeding was recurrent, in 7 cases more than twice. There were 21 women, 64 men. The largest share of erosive bleeding was idiopathic pancreatic necrosis (35.3 %). Alcoholic and postoperative pancreatic necrosis accounted for 18.8 % and 17.6 %, respectively. A comparative analysis of surgical techniques in the treatment of erosive bleeding as a complication of pancreatic necrosis was conducted. The best results were noted in semi-open methods of drainage, where preference was given to operations aimed at identifying the source of bleeding and its filling. Active surgical tactics with ligation of erosive arteries with the use of semi-open drainage methods in comparison with traditional tamponade interventions, allows to reduce mortality in erosive bleeding from 77 to 50 %.

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Minimally invasive endoscopic treatment of necrotizing pancreatitis: A case report with images and review of the literature

Cited by 3 publications

References 6 publications

Patients' Prognosis in a Pakistani Hepato-Biliary Unit Treating Acute Severe Necrotizing Pancreatitis

Patients' Prognosis in a Pakistani Hepato-Biliary Unit Treating Acute Severe Necrotizing Pancreatitis

Acute necrotizing pancreatitis: Has conservative management replaced surgery? Perspective from a tertiary care centre in Pakistan: A cross-sectional study

Surgical Tactics for Hemorrhagic Complications of Pancreonecrosis

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