PubMed Journals Articles About "Endoscopic Transgastric Necrosectomy Infected Necrotizing Pancreatitis Editorial"

Endoscopic transgastric vs surgical necrosectomy for infected necrotizing pancreatitis: a randomized trial.

Most patients with infected necrotizing pancreatitis require necrosectomy. Surgical necrosectomy induces a proinflammatory response and is associated with a high complication rate. Endoscopic transgastric necrosectomy, a form of natural orifice transluminal endoscopic surgery, may reduce the proinflammatory response and reduce complications.

Endoscopic transgastric necrosectomy for infected necrotizing pancreatitis.

Necrosectomy for infected necrotizing pancreatitis.

Endoscopic necrosectomy of pancreatic necrosis: a systematic review.

AIM: To review the current status of the novel technique of endoscopic necrosectomy in the management of pancreatic necrosis after acute pancreatitis. METHODS: Studies were identified by searching Medline, PubMed and Embase databases for articles from January 1990 to December 2009 using the keywords "acute pancreatitis", "pancreatic necrosis" and "endoscopy". Additional papers were identified by a manual search of the references from the key articles. Case series of fewer than five patients and case reports...

Endoscopic ultrasound-guided endoscopic necrosectomy of the pancreas: is irrigation necessary?

BACKGROUND: Findings have shown endoscopic necrosectomy to be beneficial for patients with symptomatic pancreatic necrosis accessible for an endoscopic approach. The available studies show that endoscopic necrosectomy requires a multitude of subsequent procedures including repeat irrigation for removal of the necrotic material. This study aimed to investigate the need for additional irrigation in patients with necrotizing pancreatitis treated by endoscopic necrosectomy....

Introduction: SSAT/AGA/ASGE State-of-the-Art Conference: Necrotizing Pancreatitis: Novel Minimally Invasive Strategies.

BACKGROUND: Necrotizing pancreatitis is the most severe end of the spectrum of acute pancreatitis. Interventional treatment (i.e., "who, when, and how") of necrotizing pancreatitis is an ongoing source of considerable controversy. Novel minimally invasive strategies are being increasingly employed to perform pancreatic necrosectomy. METHODS: The Society for Surgery of the Alimentary Tract, American Gastroenterological Association, and American Society for Gastrointestinal Endoscopy recently convened a State...

A step-up approach, or open necrosectomy for necrotizing pancreatitis.

Endoscopic necrosectomy in necrotising pancreatitis: indication is the key.

Necrotizing pancreatitis associated with severe preeclampsia.

: Necrotizing pancreatitis is rare in pregnancy and usually is associated with symptomatic cholelithiasis. We present a case of fatal necrotizing pancreatitis in a patient with severe preeclampsia.

Intra-abdominal vacuum-assisted closure (VAC) after necrosectomy for acute necrotising pancreatitis: preliminary experience.

Infection of pancreatic necrosis, although present in less than 10% of acute pancreatitis, carries a high risk of mortality; debridment and drainage of necrosis is the treatment of choice, followed by 'open' or 'close' abdomen management. We recently introduced the use of intra-abdominal vacuum sealing after a classic necrosectomy and laparostomy. Two patients admitted to ICU for respiratory insufficiency and a diagnosis of severe acute pancreatitis developed pancreatic necrosis and were treated by necrosec...

Endoscopic Pancreatic Necrosectomy.

Traditionally, patients with symptomatic sterile pancreatic necrosis or infected necrosis have been managed by open surgical debridement and removal of necrotic tissue. Within the last decade, however, reports of endoscopic pancreatic necrosectomy, an alternative minimally invasive approach, have demonstrated high success rates and low mortality rates. This report describes the indications, technique, and study outcome data of the procedure. While our experience with this technique has recently increased, b...

Large area of walled-off pancreatic necrosis successfully treated by endoscopic necrosectomy using a grasping-type scissors forceps.

Endoscopic necrosectomy (EN) for walled-off pancreatic necrosis (WOPN) is less invasive than surgical treatment and has become the first choice for pancreatic abscess. EN is usually carried out with several devices including snares, baskets, and grasping forceps. Occasionally, we have encountered cases in which EN has not been satisfactorily carried out, and there is pressure for further innovation in EN. Here, we describe a case of a large area of WOPN that was successfully treated by EN with endoscopic su...

Radiation Dose from Computed Tomography in Patients with Necrotizing Pancreatitis: How Much Is Too Much?

OBJECTIVES: Low-dose ionizing radiation from medical imaging has been indirectly linked with subsequent cancer. Computed tomography (CT) is the gold standard for defining pancreatic necrosis. The primary goal was to identify the frequency and effective radiation dose of CT imaging for patients with necrotizing pancreatitis. METHODS: All patients with necrotizing pancreatitis (2003-2007) were retrospectively analyzed for CT-related radiation exposure. RESULTS: Necrosis was identified in 18% (238/1290) of pat...

Symbiotic bacteria induced necrotizing pancreatitis.

CONTEXT: Intestinal flora and anaerobes are frequently implicated in causing infectious necrotizing pancreatitis however Bifidobacterium and Veillonella have rarely been isolated as the causative agents. Bifidobacterium and Veillonella are commensal anaerobes which reside in gastrointestinal tract and help deconjugate bile acids. Bifidobacterium is also frequently used in probiotics. CASE REPORT: We present a 68-year-old man who initially presented with gallstone pancreatitis but eventually developed Bifido...

Rational therapy of acute pancreatitis.

Management of acute pancreatitis represents a challenging aspect of everyday clinical practice that requires a multimodal and interdisciplinary approach. Mild cases of acute pancreatitis are usually self-limitating and treated with fluid resuscitation, analgesics, oxygen administration, and antiemetics. In addition to this, the role of nutritional support has been established for patients with severe acute pancreatitis with more evidence demonstrating its beneficial effects. Antibiotic prophylaxis, even tho...

History, Goals, and Technique of Laparoscopic Pancreatic Necrosectomy.

The surgical treatment of severe acute pancreatitis has significantly changed in the last several years with the advent of enhanced imaging techniques and minimally invasive surgery. Criteria for surgical intervention have been influenced by the use of step-up approaches that provide incremental multimodality interventions with repeat imaging. Here, we provide a brief introduction to the history, goals, indications, and technique of laparoscopic pancreatic necrosectomy. The technique requires a fundamental...

Treatment of Necrotizing Pancreatitis: Redefining the Role of Surgery.

BACKGROUND: Early surgical intervention in necrotizing pancreatitis (NP) is associated with high mortality. Guidelines recommend fine needle aspiration (FNA) in patients with NP and signs of sepsis. Because infection of necrosis is considered an indication for surgery, operations are often performed early. We changed treatment toward a conservative approach with FNA in selected cases only, thereby reducing the rate of necrosectomy. METHODS: Retrospectively analyzed patients, all operated on for FNA-proven i...

Analysis of the delayed approach to the management of infected pancreatic necrosis.

To analyze outcomes of delayed single-stage necrosectomy after early conservative management of patients with infected pancreatic necrosis (IPN) associated with severe acute pancreatitis (SAP).

Reply to: doi:10.1007/s00464-012-2257-9: Endoscopic ultrasound-guided endoscopic necrosectomy of the pancreas: is irrigation necessary?

Transgastric Endoscopic Retrograde Cholangiopancreatography for the Management of Biliary Tract Disease after Roux-en-Y Gastric Bypass Treatment for Obesity.

Roux-en-Y gastric bypass (RYGB) is an effective treatment for morbid obesity. However, it may lead to diseases of the bilio-pancreatic tract. We evaluated transgastric endoscopic retrograde cholangiopancreatography (ERCP) for managing common biliary tract diseases in patients that underwent RYGB treatment for obesity. This prospective study was conducted between 2003 and 2010 at three medical institutions. We included 23 patients with a mean body mass index of 28.2 kg/m(2) after RYGB treatment. ERCP was pe...

Ultrasound-guided percutaneous drainage of infected pancreatic necrosis.

BACKGROUND: The role of percutaneous drainage in the management of infected pancreatic necrosis remains controversial, and ultrasound-guided technique is rarely used for this indication. The purpose of this study was to evaluate the safety and efficacy of sonographically guided percutaneous catheter drainage for infected pancreatic necrosis. METHODS: The patient group consisted of 16 men and 2 women. The mean age of the patients was 47 years. The median computed tomography severity index of acute pancreati...

Endoscopic transmural drainage of pseudocysts associated with pancreatic resections or pancreatitis: a comparative study.

BACKGROUND: Endoscopy has been regarded as an effective modality for draining pancreatic collections, pseudocysts, and abscesses. This study analyzes our experience with endoscopic transmural drainage of pancreatic pseudocysts and compares the outcomes in patients with postsurgical and pancreatitis-associated ones. METHODS: Patients who underwent endoscopic drainage of a pancreatic pseudocyst from January 1999 through June 2008 were included in this retrospective analysis. The specific indication for attemp...

Clinical utility of an endoscopic ultrasound-guided rendezvous technique via various approach routes.

BACKGROUND: The endoscopic ultrasound-guided rendezvous techniques (EUS-rendezvous) provide reliable biliary access after failed endoscopic retrograde cholangiopancreatography (ERCP) cannulation. We evaluated the clinical utility of an EUS-rendezvous technique using various approach routes. METHODS: Patients undergoing EUS-rendezvous for biliary access after failed bile duct cannulation in ERCP were included. EUS-rendezvous was performed via three approach routes depending on the patient's condition: transg...

Complete endoscopic/transgastric retrieval of eroded gastric band: description of a novel technique and review of the literature.

Complications of laparoscopic adjustable gastric banding (LAGB) include band slippage, material infection, and band erosion. Band erosion can lead to chronic infection, obstruction, delayed perforation, and ineffectiveness; therefore, removal is indicated. A myriad of approaches exist for band removal and many authors have described novel techniques. A minimally invasive approach, including laparoscopic or endoscopic assistance, is favored given the reduction of postoperative complications compared with lap...

Endoscopic vacuum-assisted closure.

Anastomotic leakage in the upper and lower intestinal tract is associated with high morbidity and mortality. Within the last 10 years endoscopic treatment options have been accepted as sufficient treatment option of these surgical complications. Endoscopic vacuum assisted closure (E-VAC) is a new innovative endoscopic therapeutic option in this field. E-VAC transfers the positive effects of vacuum assisted closure (VAC) on infected cutaneous wounds to infected cavities that can only be reached endoscopicall...