Percutaneous transgastric irrigation drainage in combination with endoscopic necrosectomy in necrotizing pancreatitis (with videos)

Raczynski, Susanne; Teich, Niels; Borte, G.; Wittenburg, Henning; Mössner, Joachim; Caca, Karel

doi:10.1016/j.gie.2006.02.052

Cited by 59 publications

(27 citation statements)

References 10 publications

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“…[16] Percutaneous drainage can be exploited together with endoscopic drainage as a method of a multiple approach to the necrotic cavity, [9,14,17] particularly when it comes to penetration of necrosis down the abdominal cavity, up to the minor pelvis. [18] It was proved that the use of percutaneous drainage during endoscopic treatment of WOPN decreases the amount of endoscopic and radiological procedures as well as hospitalization time. [17,19] In addition, it increases the efficiency of interventional treatment of WOPN.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic transmural drainage combined with percutaneous drainage in treatment of walled-off pancreatic necrosis-case report

Jagielski

Smoczyński

Studniarek

et al. 2016

CRIM

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Pancreatic necrosis and the necrosis of surrounding tissues are found to be local complications occurring in 15% of patients suffering from acute pancreatitis. Walled-off pancreatic necrosis (WOPN) is in fact pancreatic fluid collection surrounded by a well-defined wall and inclusive of liquefied necrosis and elements (debris) of necrotic tissues. Endotherapy is an efficient method of treatment for patients with symptomatic WOPN. Often single transmural access to the necrotic collection is sufficient. However, in some patients with infected WOPN, the application of an extra way of access to pancreatic necrosis is a must. In these particular patients the optimal strategy is joining a few minimally invasive methods, which allows multiplexing of access to the collection. Herein we described the case of treatment with the use of minimally invasive techniques in a patient suffering from an infected WOPN, in which the single transmural access to the necrotic collection appeared to be insufficient and the application of an extra way of access to pancreatic necrosis was necessary. Only joining together both minimally invasive techniques-transmural drainage and percutaneous drainage had become efficient enough and led to complete healing of the patient.

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Section: Discussionmentioning

confidence: 99%

Endoscopic transmural drainage combined with percutaneous drainage in treatment of walled-off pancreatic necrosis-case report

Jagielski

Smoczyński

Studniarek

et al. 2016

CRIM

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“…Since then, several case reports have been published [28,29] . The largest series have been reported from the Mayo Clinic [15,17] .…”

Section: Discussionmentioning

confidence: 99%

EUS-Guided Endoscopic Transgastric Necrosectomy in Patients with Infected Necrosis in Acute Pancreatitis

et al. 2008

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“…Transgastric endoscopic therapy may be a less traumatic alternative to surgery and should be further assessed in prospective studies’. We reported on endoscopic drainage of infected necroses via percutaneous endoscopic gastrostomy in combination with enteral nutrition via a second percutaneous endoscopic gastrostomy [22]. The Panter Trial, a prospective multicenter trial from the Netherlands, came to the conclusion that ‘a minimally invasive step-up approach, as compared with open necrosectomy, reduced the rate of the composite end point of major complications or death among patients with necrotizing pancreatitis and infected necrotic tissue’ [23].…”

Section: Treatment Of Acute and Chronic Pancreatitismentioning

confidence: 99%

Update Lecture: Benign Diseases of the Exocrine Pancreas

Mössner¹

2011

Dig Dis

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A brief overview on the physiology and regulation of digestive enzyme secretion by the exocrine pancreas is presented. Knowledge about the physiology of the exocrine pancreas should help for a better understanding of the pathophysiology of both acute and chronic pancreatitis. In the pathophysiology of acute pancreatitis, fusion of zymogen granules with lysosomes, which leads to intracellular activation of trypsinogen, is still regarded as a key step in pathophysiology. The role of activation by cathepsins and the role of autoactivation of trypsinogen are still under debate. Studies on genetic alterations in various forms of human chronic pancreatitis can be interpreted that an imbalance between protease inhibitors and active proteases plays a key role. Toxic Ca²⁺ signals by excessive liberation from the endoplasmic reticulum may play another role. The mortality of necrotizing pancreatitis is still high. Early mortality is caused by a systemic inflammatory response syndrome with or without concomitant infection of necrosis; late mortality by multi-organ failure syndrome due to sepsis. Therapy of necroses should be performed as late as possible. A step-up approach using CT-guided and/or transgastric endoscopic necrosectomy seems to be superior to a primary surgical approach. A brief overview of the German S3 guidelines, not yet published, regarding diagnosis and treatment of chronic pancreatitis is presented.

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Percutaneous transgastric irrigation drainage in combination with endoscopic necrosectomy in necrotizing pancreatitis (with videos)

Cited by 59 publications

References 10 publications

Endoscopic transmural drainage combined with percutaneous drainage in treatment of walled-off pancreatic necrosis-case report

Endoscopic transmural drainage combined with percutaneous drainage in treatment of walled-off pancreatic necrosis-case report

EUS-Guided Endoscopic Transgastric Necrosectomy in Patients with Infected Necrosis in Acute Pancreatitis

Update Lecture: Benign Diseases of the Exocrine Pancreas

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