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Surgical Endoscopy
Erschienen in: Surgical Endoscopy 2/2013

01.02.2013

Management of infected pancreatic necrosis using retroperitoneal necrosectomy with flexible endoscope: 10 years of experience

verfasst von: Gregorio Castellanos, Antonio Piñero, Laura A. Doig, Andrés Serrano, Matilde Fuster, Vicente Bixquert

Erschienen in: Surgical Endoscopy | Ausgabe 2/2013

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Abstract

Background

This study was designed to provide our experience in the management of infected and drained pancreatic necrosis using the retroperitoneal approach.

Methods

This was a prospective observational study in a tertiary care university hospital. Thirty-two patients with confirmed infected pancreatic necrosis were studied. Superficial necrosectomy was performed with lavage and aspiration of debris. This was achieved though a retroperitoneal approach of the pancreatic area and under the direct vision of a flexible endoscope. The follow-up procedure using retroperitoneal endoscopy did not require taking the patient to the operating room. The main outcome measures were infection control, morbidity, and mortality related to technique, reintervention, and long-term follow-up.

Results

No significant morbidity or mortality related to the technique was observed in all of the patients with infected pancreatic necrosis treated with this retroperitoneal approach compared with published data using other approaches. Reinterventions were not required and patients are currently asymptomatic.

Conclusions

Retroperitoneal access of the pancreatic area is a good approach for drainage and debridement of infected pancreatic necrosis. Translumbar retroperitoneal endoscopy allows exploration under direct visual guidance avoiding open transabdominal reintervention and the risk of contamination of the abdominal cavity. This technique does not increase morbidity and mortality, can be performed at the patients’ bedside as many times as necessary, and has advantages over other retroperitoneal approaches.

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Metadaten
Titel
Management of infected pancreatic necrosis using retroperitoneal necrosectomy with flexible endoscope: 10 years of experience
verfasst von
Gregorio Castellanos
Antonio Piñero
Laura A. Doig
Andrés Serrano
Matilde Fuster
Vicente Bixquert
Publikationsdatum
01.02.2013
Verlag
Springer-Verlag
Erschienen in
Surgical Endoscopy / Ausgabe 2/2013
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-012-2455-5

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