Endotherapy for organized pancreatic necrosis: Perspective on skunk- poking

Ra, Kozarek

doi:10.1053/gast.1996.v111.agast961110820

Cited by 20 publications

(13 citation statements)

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“…In acute pancreatitis, because of the less likelihood of extensive necrosis, the ductal damage could be less severe, thus the low rates of PFC recurrence 20 . In patients with extensive pancreatic necrosis, a variable portion of the pancreatic parenchyma has no outlet for its secretions to drain, and therefore results in a “disconnected duct syndrome” causing additional ductal damage, persistent pain, liquefied necrosis, unremitting pain, and re‐accumulation of PFC 21 . In the study by Hookey et al.…”

Section: Discussionmentioning

confidence: 99%

Successful stenting in ductal disruption favorably impacts treatment outcomes in patients undergoing transmural drainage of peripancreatic fluid collections

Trevino

Tamhane

Varadarajulu

2010

J of Gastro and Hepatol

118

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Section: Discussionmentioning

confidence: 99%

Successful stenting in ductal disruption favorably impacts treatment outcomes in patients undergoing transmural drainage of peripancreatic fluid collections

Trevino

Tamhane

Varadarajulu

2010

J of Gastro and Hepatol

118

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“…Later on in their experience, the addition of a 7‐Fr nasocystic lavage catheter was felt to be responsible for a better outcome 15 . Kozarek has referred to this technique as skunk‐poking 74 …”

Section: Endoscopic Treatmentmentioning

confidence: 99%

Infected pancreatic necrosis: minimizing the cut

Wysocki

McKay

Carter

2010

ANZ Journal of Surgery

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The challenge for the pancreatologist managing patients with infected pancreatic necrosis is to devise a treatment algorithm that enables recovery but at the same time limits the morbidity and mortality. The current gold standard remains open necrosectomy. Recent literature contains scattered reports of endoscopic, radiologic, laparoscopic, percutaneous and lumbotomy approaches to managing patients with this condition. This literature review addresses the role of techniques that aim to minimize the physiological insult to the patient with infected pancreatic necrosis.

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“…The efficacy of this method was high, but at the same time, there were many complications associated with administration of the obliterating agent, including cyst wall necrosis and peritonitis. With the development of endoscopic techniques and new implantable materials, the surgeons started to perform drainage of pancreatic cysts connecting to the Wirsung's duct during endoscopic retrograde cholangiopancreatography (ECPW) (6,7). A development of this technique is the currently performed cyst marsupialization to the gastrointestinal tract and fixation of the anastomosis site using a pig tail drain (8)(9)(10).…”

Section: Discussionmentioning

confidence: 99%

Multiple orifices are better than single in the endoscopic treatment of pancreatic pseudocysts

Miłek

Ciostek²,

Kielar³

et al. 2014

Turk J Gastroenterol

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Background/Aims: The aim of this study was to compare the surgical drainage of large, symptomatic pancreatic cysts (>5 cm) with single-and multi-channel endoscopic drainage. Materials and Methods: In the period 2005-2010, we treated 112 patients with post-inflammatory pancreatic cysts. Thirty-six patients underwent surgical internal drainage. The remaining group of patients was treated endoscopically. In 28 of them, drainage was performed by anastomosing the cyst to the gastrointestinal tract using a single pig tail drain and then widening the channel to a diameter of 15 mm. Forty-eight patients underwent multi-channel cystic drainage. It consisted of connecting the cyst to the stomach and/or duodenum using at least 3 drains. Each connection was widened to a minimum diameter of 15 mm to ensure free drainage of the morphotic elements of the cyst. Each procedure was preceded by abdominal computed tomography to determine the exact location of the cyst in relation to the gastrointestinal tract and a Doppler ultrasound scan to determine the location of the blood vessels modeling on its surface. Results: In 48 patients with multi-channel drainage, there was no obstruction of the anastomosis, and cysts closed within 4 months. The drains were removed after about 3 months. The created channels were patent for about 3-4 weeks, which was enough to completely close the cyst. Conclusion: Multi-channel endoscopic anastomosis of pancreatic cyst to the gastrointestinal tract is a very effective method for drainage of large post-inflammatory pancreatic cysts, comparable in terms of effectiveness with the surgical method but less invasive.

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Endotherapy for organized pancreatic necrosis: Perspective on skunk- poking

Cited by 20 publications

References 0 publications

Successful stenting in ductal disruption favorably impacts treatment outcomes in patients undergoing transmural drainage of peripancreatic fluid collections

Successful stenting in ductal disruption favorably impacts treatment outcomes in patients undergoing transmural drainage of peripancreatic fluid collections

Infected pancreatic necrosis: minimizing the cut

Multiple orifices are better than single in the endoscopic treatment of pancreatic pseudocysts

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