Necrotizing pancreatitis remains a therapeutic challenge. Thirty-eight percent of all cases lead to an early organ failure and 15 % cause death. Interventions are necessary in 38 % 1.Due to lower mortality compared to open surgery, both endoscopic treatment and minimally invasive surgery are established 2.Endoscopic vacuum therapy can be an auxiliary method for this indication, with only a few case reports existing. Recommendation is still unclear, compared to standard methods like endoscopic necrosectomy, drainage and irrigation (see ESGE Guideline "Endoscopic management of acute necrotizing pancreatitis" 2018; Recommendation 4.2.8) 1.The actual case shows a successful endoscopic vacuum therapy of an infected walled-off pancreatic necrosis. A modified open-pore film drainage (OFD) is combined with endoscopic necrosectomy.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1055/a-0914-3502 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Predicting the need for step-up after EUS-guided drainage of peripancreatic fluid collections, including Quadrant Necrosis Infection score validation: a prospective cohort study.
Gastrointest Endosc
January 2025
Pancreatobiliary Endoscopy and Endosonography Division, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy.
Background And Aims: Factors predicting the need for step-up procedures after EUS-guided drainage (EUS-FCD) of peripancreatic fluid collections (PFCs) were explored in retrospective studies restricted to Walled-Off Necrosis (WON) and Lumen Apposing Metal Stents (LAMS).
Methods: All consecutive candidates for EUS-FCD between 2020-2024 were included in a Prospective Registry of Therapeutic EUS (PROTECT, NCT04813055), with prospective monthly follow-up evaluating clinical success, adverse events and recurrences. Prospectively assessed baseline clinical and morphological factors, including the Quadrant-Necrosis-Infection (QNI) classification, were included in a stepwise logistic regression model to predict the need for step-up.
Quadrant, necrosis, and infection criteria for the risk stratification of walled-off necrosis: external validation using multi-institutional data.
Gastrointest Endosc
January 2025
Department of Endoscopy and Endoscopic Surgery, The University of Tokyo Hospital, Tokyo, Japan; Department of Internal Medicine, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan.
Background And Aims: Endoscopic ultrasound-guided peripancreatic fluid drainage (EUS-PFD) with on-demand endoscopic necrosectomy, increasingly utilized to manage walled-off necrosis (WON), is associated with substantial morbidity and mortality. This multicenter study aimed to externally validate recently developed quadrant (an abdominal quadrant distribution), necrosis, and infection (QNI) criteria for risk stratification in this setting.
Methods: Of 423 patients with pancreatic fluid collections treated in a large multi-institutional cohort between 2010 and 2020, 212 with available preprocedural computed tomography images were included.
Clinical course for pancreatic necrosis and pancreatic pseudocysts due to severe acute or chronic pancreatitis.
Therap Adv Gastroenterol
November 2024
Section of Gastroenterology, Gastrointestinal Oncology, Hepatology, Infectiology and Geriatrics, Department of Internal Medicine I, University Hospital of Tübingen, Tübingen, Germany.
Background: The acute and chronic pancreatitis (CP) can lead to severe complications like walled-off necrosis, large symptomatic pseudocyst or multiorgan failure. The treatment of these complications is multivariate and can differ from conservative, symptomatic treatment or minimal-invasive, endoscopic transgastral stenting to transgastral necrosectomy.
Objectives: This study aims to analyse the clinical course for patients that develop local complications of severe pancreatitis.
Outcomes and Post-removal Course of Lumen-Apposing Metal Stent Placement for Peripancreatic Fluid Collections: A Comparative Study of Pancreatic Pseudocysts and Walled-Off Necrosis.
Cureus
October 2024
Gastroenterology, Chiba University, Chiba, JPN.
Aim: Pancreatic fluid collections (PFCs) are common local complications of pancreatitis that may require interventional therapy. Endoscopic ultrasound (EUS)-guided transluminal drainage from the digestive tract, particularly with lumen-apposing metal stents (LAMS), is the first-line therapy due to its safety and efficacy. However, adverse events and post-removal courses remain uncertain.
View Article and Find Full Text PDFSafety and efficacy of the EndoRotor device for the treatment of walled-off pancreatic necrosis after EUS-guided cystenterostomy: A systematic review and meta-analysis.
Endosc Ultrasound
January 2024
Center for Advanced Therapeutic Endoscopy (CATE), Porter Adventist Hospital/PEAK Gastroenterology, Denver, CO, USA.
Debridement of infected walled-off pancreatic necrosis is indicated to treat and prevent sepsis-related multiorgan failure. The aim of this study was to evaluate the efficacy and safety of the EndoRotor-powered endoscopic debridement system to remove solid debris under direct endoscopic visualization. Search strategies were developed for PubMed, EMBASE, and Cochrane Library databases from inception to June 2022, in accordance with Preferred Reporting items for Systematic Reviews and Meta-Analyses and Meta-Analysis of Observational Studies in Epidemiology guidelines.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!