Citation

Jürgensen C, Neser F, Boese-Landgraf J, Schuppan D, Stölzel U, Fritscher-Ravens A. Surg. Endosc. 2012; 26(5): 1359-1363.

Copyright

(Copyright © 2012, Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s00464-011-2039-9

PMID

unavailable

Abstract

Background Findings have shown endoscopic necrosectomy to be beneficial for patients with symptomatic pancreatic necrosis accessible for an endoscopic approach. The available studies show that endoscopic necrosectomy requires a multitude of subsequent procedures including repeat irrigation for removal of the necrotic material. This study aimed to investigate the need for additional irrigation in patients with necrotizing pancreatitis treated by endoscopic necrosectomy.

METHODS The study enrolled 35 consecutive patients (27 men) with a median age of 59 years who had pancreatic necrosis treated with endoscopic necrosectomy. Endoscopic ultrasound-guided internal drainage and consecutive endoscopic necrosectomy was combined with interval multistenting of the cavity. Neither endoscopic nor external irrigation was part of the procedure.

RESULTS An average of 6.2 endoscopy sessions per patient were needed for access, necrosectomy, and stent management. The in-hospital mortality rate was 6% (2/35), including one procedure-related death resulting from postinterventional aspiration. The immediate morbidity rate was 9% (3/35). It was possible to achieve clinical remission for all the surviving patients with no additional surgery needed for management of the necroses. The median follow-up period was 23 months.

CONCLUSION Neither endoscopic nor external flushing is needed for successful endoscopic treatment of symptomatic necroses. Even without irrigation, the outcome for patients treated with endoscopic necrosectomy is comparable to that described in the published data. © Springer Science+Business Media, LLC 2011.

Language: en

Keywords

adult; human; suicide; female; male; alcoholism; stroke; cause of death; mortality; heart failure; hospitalization; C reactive protein; comorbidity; morbidity; pancreatitis; death; article; clinical article; hospital admission; priority journal; bleeding; treatment indication; heart infarction; sepsis; heart arrest; endoscopy; diabetes mellitus; lung cancer; stent; peritoneum lavage; stomach perforation; surgical technique; neoplasm; postoperative complication; aspiration; Endoscopy; cholecystectomy; cholecystitis; endoscopic echography; varix bleeding; endoscopic surgery; artery bleeding; biliary tract disease; duodenum stenosis; endoscopic necrosectomy; intestine stenosis; pancreas necrosis; pancreas surgery; Pancreatic; pulmonary aspiration; sphincterotomy; Therapeutic/palliation; Ultrasonography; venous bleeding