Combined sinus tract endoscopy and endoscopic retrograde cholangiopancreatography in management of pancreatic necrosis and abscess

Mui, L. M.; Wong, SK; Ng, Enders Kwok Wai; Chan, Annie On On; Chung, S. C. S.

doi:10.1007/s00464-004-9120-6

Cited by 41 publications

(40 citation statements)

References 16 publications

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“…Moreover, the majority of these alternative surgical approaches require multiple separate interventions to obtain complete removal of the necrotic material, and to deal with persistent or recurrent infection. 7,12,20 The VARD approach has the advantage of avoiding peritoneal contamination, but is limited in detecting colonic ischemia, performing simultaneous cholangiography or cholecystectomy, or establishing a feeding jejunostomy at the time of debridement. 7,11 In addition, the technique of necrosis extraction is limited to the amounts of debris retrievable through the operating channel of a nephroscope or endoscope.…”

Section: Minimally Invasive Techniquesmentioning

confidence: 99%

“…Only the last clinical experience from these units was used, leaving 14 qualifying publications. [7][8][9][10][11][12][13][14][15][16][17][18][19][20] The majority of these articles dealt with minimally invasive approaches to infected necrosis. It became apparent that these publications could be further classified under three general headings: (a) video-assisted retroperitoneal debridement (VARD), (b) laparoscopic transperitoneal necrosectomy, and (c) endoscopic drainage (Tables 2 and 3).…”

Section: Minimally Invasive Techniquesmentioning

confidence: 99%

See 1 more Smart Citation

Intervention in Necrotizing Pancreatitis: An Evidence-based Review of Surgical and Percutaneous Alternatives

Bradley

Howard

Sonnenberg

et al. 2008

Journal of Gastrointestinal Surgery

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Interventional therapy in necrotizing pancreatitis is evolving. Efforts to modify or prevent pancreatic necrosis by intra-arterial infusion of antibiotics and antiproteases have been described. Moreover, traditional approaches to the surgical management of infected pancreatic necrosis are being challenged by a host of endoscopic and percutaneous techniques. While these approaches are potentially valuable additions to interventional therapy in necrotizing pancreatitis, few evidence-based studies are available to support their supplanting more traditional approaches at this time. Cooperative evidence-based multiinstitutional studies will be required to address the validity of these proposals.

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Section: Minimally Invasive Techniquesmentioning

confidence: 99%

Section: Minimally Invasive Techniquesmentioning

confidence: 99%

Intervention in Necrotizing Pancreatitis: An Evidence-based Review of Surgical and Percutaneous Alternatives

Bradley

Howard

Sonnenberg

et al. 2008

Journal of Gastrointestinal Surgery

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show abstract

“…Bruennel et al did not find a relation between the thickness, or the number of the drains and the effectiveness. With so-called 'sinus tract endoscopy' necrectomy can be performed effectively following the dilatation of the drain's channel [23,36,43]. Horvath et al performed necrosectomy via the channels of the drains with a supplementary incision using laparoscopy [16,17].…”

Section: Wwwintechopencommentioning

confidence: 99%

The Role of Percutaneous Drainage in the Treatment of Severe Acute Pancreatitis on the Basis of the Modified Atlanta Classification

Szentkereszty¹,

Kotán²,

Sápy³

2012

Acute Pancreatitis

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What to drain? Acute peripancreatic fluid collection (APFC)According to the Atlanta Classification peripancreatic fluid collection develops in the early phase of acute pancreatitis in about 40% of cases. The acute fluid collection usually develops around the pancreas but sometimes emerges in the glandular area and does not contain a high quantity of necrosis. Not rarely, it spreads into the chest, mediastinum and/or into the pararenal area. Several fluid collections can develop at the same time and can shuttle together. The rich pancreatic enzyme content of the fluid can indicate communication with the pancreatic duct or indicate parenchymal necrosis. They do not have definite walls, and are limited by the walls of the surrounding organs. In a significant number of cases (about 30-50%), spontaneous resolution occurs without surgical or other intervention. If they do not show tendency towards resolution, they can become of significant size and cause clinical symptoms or complications [5,6,33,44]. The most frequent complaints caused by a big, 8-15 cm size acute fluid collection are pain, tension, and increasing abdominal pressure which can significantly worsen the efficiency of breathing [1,9]. In other cases they can cause compression symptoms (jaundice, duodenal obstruction) or bleeding can develop inside of them. Another frequent complication is the

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“…Of these three patients, two were operated while the third died of sepsis. 16 In a matched cohort study of 12 patients who underwent PCD as part of a step up approach for WOPN, comparison was made to a similar number of patients who underwent direct endoscopic necrosectomy (DEN). 17 Clinical success was reported in a higher number of patients in DEN group (11 patients versus 3 patients).…”

Section: Percutaneous Drainage (Pcd) For Organized Collections (Pseudmentioning

confidence: 99%

Percutaneous Interventions in Acute Necrotizing Pancreatitis

Sharma¹

2016

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Acute pancreatitis (AP) is a disease of varying severity with acute necrotizing pancreatitis (ANP) being the severe form of AP. ANP needs multidisciplinary management and is associated with significant mortality and morbidity. Local complications of ANP viz. acute necrotic collections (ANC) and walled off pancreatic necrosis (WOPN) need intervention if they are associated with symptoms, sepsis or worsening organ failure. As surgery is associated with higher morbidity and mortality, there is paradigm shift in the management of these local complications with an increased emphasis on conservative and minimally invasive treatment approach. Image-guided percutaneous drainage (PCD) is a minimally invasive intervention that helps in drainage of infected collections, temporizes sepsis and improves outcomes in these patients. The present review discusses the utility of various percutaneous interventions in management of variety of pancreatic collections occurring in ANP. The available evidence, technical details and complications and emerging innovations in the field are also summarized. Acute Pancreatitis (AP) is an acute inflammatory disease of the pancreas, which is characterized by the frequent development of local or systemic complications. It is broadly divided into two morphological patterns: interstitial, which is merely associated with edema of the pancreatic parenchyma or necrotizing, in which peri-pancreatic and/or pancreatic necrosis is present. [1][2][3] In the early phase of acute pancreatitis the heightened inflammatory response dominates the clinical picture while the late phase is characterized by development of local infective as well as non-infective complications. The pancreatic inflammation results in exudation of pancreatic juice and subsequent injury to the peri-pancreatic fat and tissues. 2,3 This results in formation of collections which may be associated with both interstitial and necrotizing pancreatitis. While the collections formed in relation to interstitial pancreatitis are predominantly fluid and are called as acute fluid collections (AFC), KEYWORDS:

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Combined sinus tract endoscopy and endoscopic retrograde cholangiopancreatography in management of pancreatic necrosis and abscess

Abstract: Combined ERCP and STE is a useful adjunct in treating pancreatic necrosis or abscess.

Cited by 41 publications

References 16 publications

Intervention in Necrotizing Pancreatitis: An Evidence-based Review of Surgical and Percutaneous Alternatives

Intervention in Necrotizing Pancreatitis: An Evidence-based Review of Surgical and Percutaneous Alternatives

The Role of Percutaneous Drainage in the Treatment of Severe Acute Pancreatitis on the Basis of the Modified Atlanta Classification

Percutaneous Interventions in Acute Necrotizing Pancreatitis

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