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Surgical Step-Up Approach in Management of Necrotizing Pancreatitis.
Gastroenterol Clin North Am
March 2025
Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
Necrotizing pancreatitis often demands intervention; contemporary management is directed by the step-up approach. Timing of intervention and specific approach is best directed by a multi-disciplinary team including advanced endosocpists, interventional radiologists, and surgeons with interest and experience managing this complex problem. The intervention is often a combination of percutaneous drainage, transluminal endoscopic approaches, and surgical debridement (minimally invasive or open).
View Article and Find Full Text PDFEndoscopic Step-Up Approach in Management of Necrotizing Pancreatitis.
Gastroenterol Clin North Am
March 2025
Department of Gastroenterology, Asian Institute of Gastroenterology, AIG Hospitals, Hyderabad, India. Electronic address:
The endoscopic step-up approach in the management of necrotizing pancreatitis involves sequential steps of intervention at different time points in the clinical course of the disease. EUS -guided drainage of walled-off necrosis is the first step of the endoscopic step-up approach. Lumen-apposing metal stents are preferred over plastic stents for safe and effective drainage because of their wide caliber.
View Article and Find Full Text PDFIdentifying predictive markers for survival in malignant biliary obstruction following percutaneous transhepatic biliary drainage.
Clin Radiol
December 2024
University Hospital Southampton, Southampton General Hospital, Tremona Road, Southampton, Hampshire, SO16 6YD, UK. Electronic address:
Aim: Malignant biliary obstructive disease is commonly managed with percutaneous transhepatic biliary drainage (PTBD). Traditionally, outcomes are evaluated collectively despite substantial variability in the underlying aetiology and extent of disease. The purpose of this study was to investigate whether variability in survival could be explained by different underlying patient and disease factors.
View Article and Find Full Text PDFA Novel Approach to the Management of an Intra-abdominal Abscess: A Case Report and Literature Review.
Cureus
January 2025
Department of Surgery, Harlem Hospital/Columbia University, New York, USA.
Exploratory laparotomies for blunt or penetrating trauma often result in significant morbidity. Despite advancements in resuscitation, surgical techniques, and antibiotics, intra-abdominal abscesses remain a serious complication, contributing to poor outcomes and extended hospital stays. Percutaneous computed tomography-guided drainage is the standard treatment for abscesses, offering high success rates and low morbidity.
View Article and Find Full Text PDFClinical evaluation of endoscopic biliary stenting in treatment of malignant obstructive jaundice.
World J Gastrointest Surg
January 2025
Department of General Surgery, Shenzhen University General Hospital, Shenzhen 518000, Guangdong Province, China.
Background: Malignant obstructive jaundice (MOJ) is characterized by the presence of malignant tumors infiltrating or compressing the bile duct, causing poor bile drainage, generalized yellowing, pain, itching, and malaise. MOJ is burdensome for both the society and the families of affected patients and should be taken seriously.
Aim: To evaluate the clinical effect of stent placement during endoscopic retrograde cholangiopancreatography for relieving MOJ and the efficacy of percutaneous transhepatic biliary drainage in terms of liver function improvement, complication rates, and long-term patient outcomes.
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