Acute pancreatitis in children is rarely complicated by the development of necrosis. Although endoscopic transluminal necrosectomy is evolving as the standard of care in adults, its feasibility in the pediatric population has not been established. We hereby report the first case series of children with necrotizing pancreatitis successfully treated with endoscopic therapy. We believe the use of fully covered self-expanding metallic stents in the cystgastrostomy may reduce the number of transluminal necrosectomy sessions for large necrotic collections in children.
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http://dx.doi.org/10.1097/MPG.0000000000000416 | DOI Listing |
Cureus
September 2024
General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Researc, Wardha, IND.
Necrotizing pancreatitis (NP) is a severe complication of acute pancreatitis, characterized by necrosis of pancreatic and peripancreatic tissues, leading to significant morbidity and mortality. The role of necrosectomy, the surgical removal of necrotic tissue, in the management of NP has evolved over the past few decades, moving from early aggressive surgical intervention to a more conservative and stepwise approach. This narrative review explores the historical perspectives, current practices, and future trends in the role of necrosectomy in NP.
View Article and Find Full Text PDFDig Endosc
January 2025
Japan Gastroenterological Endoscopy Society, Tokyo, Japan.
J Dig Dis
August 2024
Department of Gastroenterology, Xinqiao Hospital, Army Medical University, Chongqing, China.
Objectives: Endoscopic necrosectomy (EN) is a promising minimally invasive approach for treating infected walled-off pancreatic necrosis (WOPN). Multiple EN approaches are currently available, though criteria for selecting the optimal approaches are lacking. We aimed to propose a rational selection strategy of EN and to retrospectively evaluate its safety and effectiveness.
View Article and Find Full Text PDFIndian J Gastroenterol
June 2024
Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, Erasme University Hospital, HUB, Université Libre de Bruxelles, Brussels, Belgium.
Acute necrotizing pancreatitis is a common gastrointestinal disease requiring hospitalization and multiple interventions resulting in higher morbidity and mortality. Development of infection in such necrotic tissue is one of the sentinel events in natural history of necrotizing pancreatitis. Infected necrosis develops in around 1/3rd of patients with necrotizing pancreatitis resulting in higher mortality.
View Article and Find Full Text PDFDig Dis Sci
May 2024
Department of Gastroenterology, Post Graduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh, 160012, India.
Endoscopic transmural drainage is usually performed for symptomatic well-encapsulated walled-off necrosis (WON) that usually develops in the delayed phase (> 4 weeks after disease onset) of acute necrotising pancreatitis (ANP). Endoscopic drainage is usually not advocated in the early (< 4 weeks after disease onset) stage of illness because of the risk of complications due to an incompletely formed encapsulating wall and poor demarcation of viable from necrotic tissue. However, emerging data from expert tertiary care centres over the last few years shows that the early endoscopic transluminal drainage approach is effective and safe.
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