Interventional radiology-assisted transgastric endoscopic drainage of peripancreatic fluid collections

Hawel, Jeffrey; McFadgen, H.; Stewart, Richard D.; El-Ghazaly, Tarek H.; Alawashez, Abdulrahim; Ellsmere, James

doi:10.1503/cjs.003019

Cited by 2 publications

(2 citation statements)

References 6 publications

(6 reference statements)

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“…Deep-seated abscess with interposition of organs can be drained with a surgical approach or the intervening organ can be traversed with a catheter[ 72 ]. This approach is not suitable for almost all abdominal organs, except the stomach and the liver[ 72 , 73 ]. Finally, transvaginal and transrectal drainage with US or CT guidance allows access to deep-seated abscesses beside the vagina or rectum, often resulting from gynecological or rectal cancers, and inaccessible with percutaneous methods[ 74 , 75 ].…”

Section: Ir In Gi Cancers Treatmentmentioning

confidence: 99%

Current trends and perspectives in interventional radiology for gastrointestinal cancers

Reitano¹,

de’Angelis²,

Bianchi³

et al. 2021

WJR

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Gastrointestinal (GI) cancers often require a multidisciplinary approach involving surgeons, endoscopists, oncologists, and interventional radiologists to diagnose and treat primitive cancers, metastases, and related complications. In this context, interventional radiology (IR) represents a useful minimally-invasive tool allowing to reach lesions that are not easily approachable with other techniques. In the last years, through the development of new devices, IR has become increasingly relevant in the context of a more comprehensive management of the oncologic patient. Arterial embolization, ablative techniques, and gene therapy represent useful and innovative IR tools in GI cancer treatment. Moreover, IR can be useful for the management of GI cancer-related complications, such as bleeding, abscesses, GI obstructions, and neurological pain. The aim of this study is to show the principal IR techniques for the diagnosis and treatment of GI cancers and related complications, as well as to describe the future perspectives of IR in this oncologic field.

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Section: Ir In Gi Cancers Treatmentmentioning

confidence: 99%

Current trends and perspectives in interventional radiology for gastrointestinal cancers

Reitano¹,

de’Angelis²,

Bianchi³

et al. 2021

WJR

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show abstract

“…In recent years, minimally-invasive surgical treatment techniques, percutaneous catheter drainage (PCD), laparoscopic cystogastrostomy (LC), and video-assisted retroperitoneal debridement (VARD) have become the first choice for surgery (5)(6)(7). With the gradual development of endoscopic technology, endoscopic transgastric necrosectomy (ETN) and endoscopic transgastric drainage (ETD) technologies have also been promoted and applied clinically, realizing excellent therapeutic effects (8,9). In the past 10 years, in the invasive treatment of necrotizing pancreatitis, the traditional open debridement has been gradually replaced by minimally invasive surgery.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of digestive endoscopy and surgery in the treatment of necrotizing pancreatitis: a meta-analysis and systematic review

Tang¹,

Zha²,

Zhou³

et al. 2021

Gland Surg

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Background: Digestive endoscopy and surgery are the primary invasive methods for the clinical treatment of necrotizing pancreatitis. However, there are relatively few studies evaluating the effectiveness and safety of these two methods. Methods: Randomized controlled trials (RCTs) on endoscopic and surgical treatment of necrotizing pancreatitis published from January 2000 to December 2020 were searched in the PubMed, Medline, Embase, China Biology Medicine Disc (CBM), and WanFang databases. The Cochrane System Review Manual was adopted to evaluate the quality of the included literature, and Review Manager 5.3 was used for data analysis. Results: Ten articles were included in this meta-analysis, involving a total of 401 patients, including 188 in the endoscopy group and 213 in the surgery group. Meta-analysis results revealed that the clinical remission rate (CRR) [odds ratio (OR) =1.30, 95% confidence interval (CI): 0.58-2.92, P=0.52], new organ failure rate (OFR) (OR =0.53, 95% CI: 0.26-1.09, P=0.08), abdominal bleeding rate (ABR) (OR =0.62, 95% CI: 0.33-1.15, P=0.13), and intensive care unit (ICU) stay time (IST) [mean deviation (MD) =−7.33, 95% CI: −16.76 to 2.11, P=0.13] were not significantly different between the endoscopy and surgery groups. In the endoscopy group, the mortality rate (OR =0.56, 95% CI: 0.31-1.02, P=0.05), intestinal fistula rate (IFR) or gastrointestinal perforation rate (GPR) (OR =0.50, 95% CI: 0.26-0.99, P=0.05), and pancreatic fistula rate (PFR) (OR =0.09, 95% CI: 0.04-0.23, P<0.00001) were markedly lower compared to the surgery group.Discussion: There was no obvious difference in the clinical efficacy of endoscopic and surgical treatment of necrotizing pancreatitis. However, endoscopy can greatly reduce the incidence of postoperative death and major complications in patients.

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Interventional radiology-assisted transgastric endoscopic drainage of peripancreatic fluid collections

Cited by 2 publications

References 6 publications

Current trends and perspectives in interventional radiology for gastrointestinal cancers

Current trends and perspectives in interventional radiology for gastrointestinal cancers

Effectiveness of digestive endoscopy and surgery in the treatment of necrotizing pancreatitis: a meta-analysis and systematic review

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