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Multimodal necrosectomy with full combined endoscopic necrosectomy in the management of acute necrotizing pancreatitis.
Ther Adv Gastrointest Endosc
November 2023
Department of Gastroenterology, Hôpital Nord, AP-HM, Aix-Marseille Université, Marseille, France.
Transgastric and transduodenal endoscopic drainages and necrosectomy are minimally invasive and effective way for the treatment of infected necrosis in the setting of acute pancreatitis (AP), but are limited in case of large and distant collections or in case of altered anatomy. We present an exclusively endoscopic approach consisting of multimodal endoscopic necrosectomy. We included consecutive patients with severe AP and presenting with large and infected necrosis requiring one transgastric and at least one extra-gastric access, among which are percutaneous, transcolonic, and/or transgrelic access.
View Article and Find Full Text PDFBalloon ride to WONderland: Balloon overtube-assisted transduodenal necrosectomy for walled-off pancreatic necrosis.
Dig Endosc
September 2023
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Endoscopic Treatment of Complex Walled-Off Necrosis in Necrotizing Pancreatitis With Two Simultaneous Lumen-Apposing Metal Stents: A Case Report.
Cureus
October 2022
Serviço de Endoscopia Gastrointestinal do Departamento de Gastroenterologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, BRA.
Organized pancreatic and peripancreatic collections are complications of pancreatitis and should be treated when symptomatic or complicated. When feasible, the endoscopic ultrasound approach presents high efficacy and low morbidity and mortality, making it the first likely option. Among the available accessories for endoscopic drainage, the lumen-apposing metal stent can be a better option, with a low migration rate; furthermore, it allows endoscopic necrosectomy.
View Article and Find Full Text PDFOver-the-scope-grasper: A new tool for pancreatic necrosectomy and beyond - first multicenter experience.
World J Gastrointest Surg
August 2022
Department of Internal Medicine II, University of Würzburg, Würzburg 97080, Germany.
Background: Endoscopic treatment of pancreatic necrosis can be challenging and time-consuming because sticky necrotic debris is sometimes difficult to remove. The over-the-scope-grasper, a new tool that has recently become available for this purpose, might also be useful for other indications. However, clinical data on the efficacy and safety of this new device are lacking.
View Article and Find Full Text PDFPercutaneous Endoscopic Necrosectomy of Complex Walled-Off Lateral Necrosis of the Pancreas with the Aid of Laparoscopic Babcock Forceps: A Case Report of an Endoscopic and Radiologic Team Approach.
Perm J
April 2020
University of California, Riverside, School of Medicine.
Introduction: The initial therapeutic intervention for infected necrotizing pancreatitis usually begins with endoscopic cystogastrostomy for drainage, followed by endoscopic necrosectomy. Endoscopic pancreatic necrosectomy is commonly performed transluminally through transgastric or transduodenal routes. This case describes necrosectomy via a transcutaneous route for laterally located walled-off pancreatic necrosis and the novel use of Babcock forceps for an obstructed fully covered metal stent.
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