Management of (Peri)Pancreatic Collections in Acute Pancreatitis

Bezmarević, Mihailo; Dijk, Sven M. van; Voermans, Rogier P.; Santvoort, Hjalmar C. van; Besselink, Marc G.

doi:10.1159/000499631

Cited by 30 publications

(40 citation statements)

References 60 publications

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“…of them has been designed for such an indication [3][4][5][6]. The limitations of a snare are that, in soft tissue, the snare often cuts through the tissue instead of grabbing it.…”

Section: Discussionmentioning

confidence: 99%

The over-the-scope grasper (OTSG)

Brand

Hofmann²,

Ho³

et al. 2020

Endoscopy

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Background Endoscopic removal of foreign bodies, coagulated blood or necrotic debris is sometimes challenging and time consuming, also due to inadequate endoscopic instruments. Therefore, new devices are needed to overcome current limitations. Methods The OTSG is a new grasping tool that can be attached to any standard gastroscope. It has been developed for endoscopic removal of larger particles. We present retrospective data of five patients treated with the device for various indications (necrosectomy. bolus impaction, removal of blood clots). Results In two patients the OTSG was used for direct endoscopic necrosectomy after severe pancreatitis through a lumen-apposing metal stent. The other patients had a massive blood clot in the esophagus after endoscopic submucosal dissection, or aphagia due to large meat chunks clogging the esophagus, respectively. The OTSG has been used in all cases with technical success and without any procedure associated complications. Conclusion The OTSG appears to be a useful device for endoscopic removal of larger particles, blood clots or necrotic debris. Preliminary experience shows that the device is effective and easy to apply.

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“…of them has been designed for such an indication [3][4][5][6]. The limitations of a snare are that, in soft tissue, the snare often cuts through the tissue instead of grabbing it.…”

Section: Discussionmentioning

confidence: 99%

The over-the-scope grasper (OTSG)

Brand

Hofmann²,

Ho³

et al. 2020

Endoscopy

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“…Большинство псевдокист поджелудочной железы возникают после перенесенного острого и хронического панкреатита [15,19]. Клиническая картина пациентов с псевдокистой поджелудочной железы варьируется от бессимптомной до серьезной абдоминальной патологии из-за осложнений [20].…”

Section: диагностикаunclassified

Current treatment of pancreatic pseudocysts: a systematic review

Durleshter¹,

Генрих

Макаренко³

et al. 2021

Kuban. nauсh. med. vestnik

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Background. Pancreatic pseudocysts stand among current challenges in modern medicine. Their treatment uses variant instrumental techniques and implies a multispecialty approach. Trials in surgery and gastroenterology have aimed to identify an optimal strategy to tackle pancreatic pseudocysts for reducing complications and the recurrence rate, suggesting ultrasound-guided percutaneous, laparoscopic and flexible endoscopic drainage as promising treatment choices.Objectives. A summarising review of diagnostic and therapeutic methods for pancreatic pseudocyst treatment and comparison of ultrasound-guided percutaneous vs. surgical and endoscopic drainage techniques.Methods. The review examines the classification, epidemiology and methods for diagnosis and treatment of pancreatic pseudocysts. Only comparative full-text studies published within 2014–2021, as well as selected impactive publications within 2002–2013, have been included. The eLibrary, Elsevier and PubMed resources were queried for the article or journal title fields against the keywords (separate or combined) “pancreatic pseudocyst” [псевдокиста поджелудочной железы], “pseudocyst drainage” [дренирование псевдокисты], “surgical drainage” [хирургическое дренирование], “endoscopic drainage” [эндоскопическое дренирование], cystogastrostomy [цистогастростомия], gastrojejunostomy [гастроеюностомия], “duodenal-cystic anastomosis” [цистодуоденоанастомоз], “transpapillary drainage” [транспапиллярное дренирование], “transmural drainage and esophagogastroduodenoscopy” [трансмуральное дренирование и эзофагогастродуоденоскопия]. Records have been selected for topic-related scientific value.Results. The review systematically surveys 68 scientific papers in the focus area and summarises the most common surgical methods for pancreatic pseudocyst treatment. Based on the main principle, the methods are classified into three categories, ultrasound-guided percutaneous drainage, surgical drainage and flexible endoscopic drainage. The major classifications and treatment techniques are highlighted for their advantages and disadvantages.Conclusion. There exist no generally adopted strategy for pancreatic pseudocyst treatment in current clinical practice and no evidence on a particular method application in a large patient cohort. The publication survey identifies the techniques of percutaneous, surgical and endoscopic drainage with ultrasound control as highly effective overall among other surgical treatments.

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“…So, APFC and PP strictly consist of enzyme rich fluid without necrotic debris and thus will never develop in the setting of necrotizing pancreatitis. APFC and PP may arise as a result of fluid exudation secondary to pancreatic inflammation or may be associated with disruption of the main pancreatic duct or one of the side branches of the pancreatic duct [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

The effectiveness of image-guided percutaneous catheter drainage in the management of acute pancreatitis-associated pancreatic collections

et al. 2021

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IntroductionAcute pancreatitis is commonly complicated by the development of pancreatic collections (PCs). Symptomatic PCs warrant drainage, and the available options include percutaneous, endoscopic, and open surgical approaches. The study aimed to assess the therapeutic effectiveness and safety of image guided percutaneous catheter drainage (PCD) in the management of acute pancreatitis related PCs.Material and methodsThis was a single-centre prospective study covering a 4-year study period. Acute pancreatitis-related PCs complicated by secondary infection or those producing symptoms due to pressure effect on surrounding structures were enrolled and underwent ultrasound or computed tomography (CT)-guided PCD. The patients were followed to assess the success of PCD (defined as clinical, radiological improvement, and the avoidance of surgery) and any PCD-related complications.ResultsThe study included 60 patients (60% males) with a mean age of 43.1 ± 21.2 years. PCD recorded a success rate of 80% (16/20) for acute peripancreatic fluid collections (APFC) and pancreatic pseudocysts (PPs), 75% (12/16) for walled-off necrosis (WON), and 50% (12/24) for acute necrotic collections (ANCs). Post-PCD surgery (necrosectomy ± distal pancreatectomy) was needed in 50% of ANC and 25% of WON. Only 20% of APFCs/PPs patients required surgical/endoscopic treatment post-PCD. Minor procedure-related complications were seen in 4 (6.6%) patients.ConclusionsPCD is an effective, safe, and minimally invasive therapeutic modality with a good success rate in the management of infected/symptomatic PCs.

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Management of (Peri)Pancreatic Collections in Acute Pancreatitis

Cited by 30 publications

References 60 publications

The over-the-scope grasper (OTSG)

The over-the-scope grasper (OTSG)

Current treatment of pancreatic pseudocysts: a systematic review

The effectiveness of image-guided percutaneous catheter drainage in the management of acute pancreatitis-associated pancreatic collections

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