BACKGROUND: The degree of necrosis and presence of infection are the crucial determinants of the outcome in patients with pancreatic necrosis. In patients with sterile necrosis, the necrotic material can persist and subsequently results in sepsis. Some of these patients will ultimately require an operation to remove the necrotic material. Percutaneous necrosectomy has been introduced to remove this residual debris in a minimally invasive way. METHODS: We retrospectively reviewed all patients with pancreatic necrosis who had percutaneous drainage (PCD) performed. Percutaneous pancreatic necrosectomy (PCPN) was done for those patients whose necrotic cavity failed to resolve. RESULTS: Percutaneous drainage was performed in eight patients, four with evidence of infection by the positive culture in the aspirate. In three of them, the necrotic cavity completely resolved after drainage. Percutaneous necrosectomy was performed in another three patients through the tract placed by the radiologist and another one through a sinus tract after an operation. The necrotic cavity in three of them completely resolved after percutaneous necrosectomy. CONCLUSION: Those patients who had 'organized necrosis' after the acute episode of pancreatitis could receive benefit from percutaneous necrosectomy. The persistent symptoms could be alleviated after the removal of the residual necrotic material. It could also be useful after an open surgery to remove any residual devitalized tissue.
BACKGROUND: The degree of necrosis and presence of infection are the crucial determinants of the outcome in patients with pancreatic necrosis. In patients with sterile necrosis, the necrotic material can persist and subsequently results in sepsis. Some of these patients will ultimately require an operation to remove the necrotic material. Percutaneous necrosectomy has been introduced to remove this residual debris in a minimally invasive way. METHODS: We retrospectively reviewed all patients with pancreatic necrosis who had percutaneous drainage (PCD) performed. Percutaneous pancreatic necrosectomy (PCPN) was done for those patients whose necrotic cavity failed to resolve. RESULTS: Percutaneous drainage was performed in eight patients, four with evidence of infection by the positive culture in the aspirate. In three of them, the necrotic cavity completely resolved after drainage. Percutaneous necrosectomy was performed in another three patients through the tract placed by the radiologist and another one through a sinus tract after an operation. The necrotic cavity in three of them completely resolved after percutaneous necrosectomy. CONCLUSION: Those patients who had 'organized necrosis' after the acute episode of pancreatitis could receive benefit from percutaneous necrosectomy. The persistent symptoms could be alleviated after the removal of the residual necrotic material. It could also be useful after an open surgery to remove any residual devitalized tissue.
Authors: Mohamed Abdelhafez; Mayada Elnegouly; M S Hasab Allah; Mostafa Elshazli; Hany M S Mikhail; Ayman Yosry Journal: Surg Endosc Date: 2013-04-13 Impact factor: 4.584
Authors: T Bruennler; J Langgartner; S Lang; C E Wrede; F Klebl; S Zierhut; S Siebig; F Mandraka; F Rockmann; B Salzberger; S Feuerbach; J Schoelmerich; O W Hamer Journal: World J Gastroenterol Date: 2008-02-07 Impact factor: 5.742
Authors: T Bruennler; J Langgartner; S Lang; N Zorger; T Herold; B Salzberger; S Feuerbach; J Schoelmerich; O W Hamer Journal: Eur Radiol Date: 2008-03-21 Impact factor: 5.315
Authors: Georgios I Papachristou; Naoki Takahashi; Prabhleen Chahal; Michael G Sarr; Todd H Baron Journal: Ann Surg Date: 2007-06 Impact factor: 12.969