Pancreatic Necrosectomy through Sinus Tract Endoscopy
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Background/Aims: Direct endoscopic pancreatic necrosectomy is increasingly being utilized to treat infected or symptomatic walledoffnecrosis (WON) located close to the stomach or duodenum. Laterally-placed WON has traditionally been treated surgically. Weevaluated a less utilized technique of sinus tract endoscopy (STE) for symptomatic laterally-placed WON. Methods: Two hundred seventy-six patients with acute pancreatitis admitted in our hospital, 32 had symptomatic or infected WONrequiring intervention. Of the 12 patients with laterally placed WON, 10 were treated by STE. STE was performed with a standard adultgastroscope passed through a percutaneous tract created by the placement of a 32-Fr drain. Results: Ten patients (7 males; mean age, 43.8 years) underwent STE. Mean number of sessions was 2.3 (range, 1–4), with mean timeof 70 minutes for each session (range, 15–70 minutes). While 9 patients had complete success, 1 patient had fever and chose to undergosurgery. Two patients developed pneumoperitoneum, which was treated conservatively. There was no mortality, cutaneous fistula, orrecurrence during follow-up. Conclusions: Laterally placed WON can be successfully managed by STE performed through a percutaneously placed drain. Details ofthe technique and end-points of STE require further evaluation.
Abstract
Background/Aims: Direct endoscopic pancreatic necrosectomy is increasingly being utilized to treat infected or symptomatic walledoffnecrosis (WON) located close to the stomach or duodenum. Laterally-placed WON has traditionally been treated surgically. Weevaluated a less utilized technique of sinus tract endoscopy (STE) for symptomatic laterally-placed WON. Methods: Two hundred seventy-six patients with acute pancreatitis admitted in our hospital, 32 had symptomatic or infected WONrequiring intervention. Of the 12 patients with laterally placed WON, 10 were treated by STE. STE was performed with a standard adultgastroscope passed through a percutaneous tract created by the placement of a 32-Fr drain. Results: Ten patients (7 males; mean age, 43.8 years) underwent STE. Mean number of sessions was 2.3 (range, 1–4), with mean timeof 70 minutes for each session (range, 15–70 minutes). While 9 patients had complete success, 1 patient had fever and chose to undergosurgery. Two patients developed pneumoperitoneum, which was treated conservatively. There was no mortality, cutaneous fistula, orrecurrence during follow-up. Conclusions: Laterally placed WON can be successfully managed by STE performed through a percutaneously placed drain. Details ofthe technique and end-points of STE require further evaluation.
참고문헌 (38)
- Besselink MG, "Timing and impact of infections in acute pancreatitis", Br J Surg, 96, pp.267~273 (2009)[DOI]
- Petrov MS, "Organ failure and infection of pancreatic necrosis as determinants of mortality in patients with acute pancreatitis", Gastroenterology, 139, pp.813~820 (2010)[DOI]
- Whitcomb DC, "Clinical practice. Acute pancreatitis", N Engl J Med, 354, pp.2142~2150 (2006)[DOI]
- Gloor B, "Late mortality in patients with severe acute pancreatitis", Br J Surg, 88, pp.975~979 (2001)[DOI]
- Garg PK, "Association of extent and infection of pancreatic necrosis with organ failure and death in acute necrotizing pancreatitis", Clin Gastroenterol Hepatol, 3, pp.159~166 (2005)[DOI]
- Tenner S, "American college of gastroenterology guideline: management of acute pancreatitis", Am J Gastroenterol, 108, pp.1400~1415 (2013)[DOI]
- Freeman ML, "Interventions for necrotizing pancreatitis: summary of a multidisciplinary consensus conference", Pancreas, 41, pp.1176~1194 (2012)[DOI]
- Werner J, "Surgery in the treatment of acute pancreatitis--open pancreatic necrosectomy", Scand J Surg, 94, pp.130~134 (2005)[DOI]
- Baron TH, "Endoscopic therapy for organized pancreatic necrosis", Gastroenterology, 111, pp.755~764 (1996)[DOI]
- Seifert H, "Retroperitoneal endoscopic debridement for infected peripancreatic necrosis", Lancet, 356, pp.653~655 (2000)[DOI]
- Working Group IAP, "APA Acute Pancreatitis Guidelines", IAP, Pancreatology, pp.2013, 13(4 Suppl 2)[DOI]
- Larvin M, "Management of infected pancreatic necrosis", Curr Gastroenterol Rep, 10, pp.107~114 (2008)[DOI]
- van Santvoort HC, "A step-up approach or open necrosectomy for necrotizing pancreatitis", N Engl J Med, 362, pp.1491~1502 (2010)[DOI]
- Trikudanathan G, "Endoscopic interventions for necrotizing pancreatitis", Am J Gastroenterol, 109, pp.969~981 (2014)[DOI]
- van Santvoort HC, "A conservative and minimally invasive approach to necrotizing pancreatitis improves outcome", Gastroenterology, 141, pp.1254~1263 (2011)[DOI]
- Gluck M, "Endoscopic and percutaneous drainage of symptomatic walled-off pancreatic necrosis reduces hospital stay and radiographic resources", Clin Gastroenterol Hepatol, 8, pp.1083~1088 (2010)[DOI]
- Ross AS, "Dual-modality drainage of infected and symptomatic walled-off pancreatic necrosis: long-term clinical outcomes", Gastrointest Endosc, 79, pp.929~935 (2014)[DOI]
- Bakker OJ, "Endoscopic transgastric vs surgical necrosectomy for infected necrotizing pancreatitis: a randomized trial", JAMA, 307, pp.1053~1061 (2012)[DOI]
- Mouli VP, "Efficacy of conservative treatment, without necrosectomy, for infected pancreatic necrosis: a systematic review and meta-analysis", Gastroenterology, 144, pp.333~340 (2013)[DOI]
- Runzi M, "Severe acute pancreatitis: nonsurgical treatment of infected necroses", Pancreas, 30, pp.195~199 (2005)[DOI]
- Lee JK, "The efficacy of nonsurgical treatment of infected pancreatic necrosis", Pancreas, 34, pp.399~404 (2007)[DOI]
- Hart PA, "What is the role of noninvasive treatment for infected pancreatic necrosis: still an unanswered question", Gastroenterology, 144, pp.1574~1575 (2013)[DOI]
- Seifert H, "Transluminal endoscopic necrosectomy after acute pancreatitis: a multicentre study with long-term follow-up (the GEPARD study)", Gut, 58, pp.1260~1266 (2009)[DOI]
- Charnley RM, "Endoscopic necrosectomy as primary therapy in the management of infected pancreatic necrosis", Endoscopy, 38, pp.925~928 (2006)[DOI]
- Rische S, "Transmural endoscopic necrosectomy of infected pancreatic necroses and drainage of infected pseudocysts: a tailored approach", Scand J Gastroenterol, 48, pp.231~240 (2013)[DOI]
- Escourrou J, "Peroral transgastric", transduodenal necrosectomy: success in the treatment of infected pancreatic necrosis, 2008, pp.248, 1074~1080
- Yasuda I, "Japanese multicenter experience of endoscopic necrosectomy for infected walled-off pancreatic necrosis: The JENIPaN study", Endoscopy, 45, pp.627~634 (2013)[DOI]
- Gardner TB, "Endoscopic management of necrotizing pancreatitis", Gastrointest Endosc, 76, pp.1214~1223 (2012)[DOI]
- Carter CR, "Percutaneous necrosectomy and sinus tract endoscopy in the management of infected pancreatic necrosis: an initial experience", Ann Surg, 232, pp.175~180 (2000)[DOI]
- Mui LM, "Combined sinus tract endoscopy and endoscopic retrograde cholangiopancreatography in management of pancreatic necrosis and abscess", Surg Endosc, 19, pp.393~397 (2005)[DOI]
- Dhingra R, "Single or multiport percutaneous endoscopic necrosectomy performed with the patient under conscious sedation is a safe and effective treatment for infected pancreatic necrosis (with video)", Gastrointest Endosc, 81, pp.351~359 (2015)[DOI]
- Abdelhafez M, "Transluminal retroperitoneal endoscopic necrosectomy with the use of hydrogen peroxide and without external irrigation: a novel approach for the treatment of walled-off pancreatic necrosis", Surg Endosc, 27, pp.3911~3920 (2013)[DOI]
- Bucher P, "Minimally invasive necrosectomy for infected necrotizing pancreatitis", Pancreas, 36, pp.113~119 (2008)[DOI]
- Ammori BJ, "Laparoscopic transgastric pancreatic necrosectomy for infected pancreatic necrosis", Surg Endosc, 16, pp.1362~ (2002)[DOI]
- Horvath KD, "Laparoscopic assisted percutaneous drainage of infected pancreatic necrosis", Surg Endosc, 15, pp.677~682 (2001)[DOI]
- Horvath KD, "A technique for laparoscopic-assisted percutaneous drainage of infected pancreatic necrosis and pancreatic abscess", Surg Endosc, 15, pp.1221~1225 (2001)[DOI]
- Freeny PC, "Infected pancreatic fluid collections: percutaneous catheter drainage", Radiology, 167, pp.435~441 (1988)[DOI]
- Gambiez LP, "Retroperitoneal approach and endoscopic management of peripancreatic necrosis collections", Arch Surg, 133, pp.66~72 (1998)[DOI]