Negative pressure irrigation and endoscopic necrosectomy through man-made sinus tract in infected necrotizing pancreatitis: a technical report
Version 2 2019-10-24, 12:59
Version 1 2016-12-15, 06:11
Posted on 2019-10-24 - 12:59
Abstract Background In recent years, a step-up approach based on minimally invasive techniques was recommended by latest guidelines as initial invasive treatment for infected pancreatic necrosis (IPN). In this study, we aimed to describe a novel step-up approach for treating IPN consisting of four steps including negative pressure irrigation (NPI) and endoscopic necrosectomy (ED) as a bridge between percutaneous catheter drainage (PCD) and open necrosectomy Methods A retrospective review of a prospectively collected internal database of patients with a diagnosis of IPN between Jan, 2012 to Dec, 2012 at a single institution was performed. All patients underwent the same drainage strategy including four steps: PCD, NPI, ED and open necrosectomy. The demographic characteristics and clinical outcomes of study patients were analyzed. Results A total of 71 consecutive patients (48 males and 23 females) were included in the analysis. No significant procedure-related complication was observed and the overall mortality was +21.1Â % (15 of 71 patients). Seven different strategies like PCD+ NPI, PCD+NPI+ED, PCD+open necrosectomy, etcetera, were applied in study patients and a half of them received PCD alone. In general, each patient underwent a median of 2 drainage procedures and the median total drainage duration was 11Â days (interquartile range, 6â21days). Conclusions This four-step approach is effective in treating IPN and adds no extra risk to patients when compared with other latest step-up strategies. The two novel techniques (NPI and ED) could offer distinct clinical benefits without posing unanticipated risks inherent to the procedures.
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Tong, Zhihui; Ke, Lu; Li, Baiqiang; Li, Gang; Zhou, Jing; Shen, Xiao; et al. (2016). Negative pressure irrigation and endoscopic necrosectomy through man-made sinus tract in infected necrotizing pancreatitis: a technical report. figshare. Collection. https://doi.org/10.6084/m9.figshare.c.3627362.v2
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AUTHORS (9)
ZT
Zhihui Tong
LK
Lu Ke
BL
Baiqiang Li
GL
Gang Li
JZ
Jing Zhou
XS
Xiao Shen
WL
Weiqin Li
NL
Ning Li
JL
Jieshou Li