M Smoczyński1, I Marek2, M Dubowik2, G Rompa2, J Kobiela3, M Studniarek4, J Pieńkowska4, K Adrych2. 1. Department of Gastroenterology and Hepatology of Medical University of Gdańsk, Gdańsk, Poland. Electronic address: kgastro@gumed.edu.pl. 2. Department of Gastroenterology and Hepatology of Medical University of Gdańsk, Gdańsk, Poland. 3. Department of General, Endocrine and Transplant Surgery of Medical University of Gdańsk, Poland. 4. Department of Radiology of Medical University of Gdańsk, Poland.
Abstract
BACKGROUND: Endoscopic drainage of the pancreatic pseudocysts has been accepted as a valid alternative to surgical and percutaneous drainage. Endoscopic treatment of the symptomatic walled-off necrosis was not, however, univocally accepted by all authors. THE AIM: The aim of this study was to assessed the effectiveness and safety of the endoscopic drainage of walled-off necrosis. METHODS AND MATERIAL: Between 2001 and 2011 one hundred and twelve patients with symptomatic walled-off necrosis were treated in the Department of Gastroenterology and Hepatology of the Medical University of Gdansk, using endoscopic drainage. The drainage system was set up by introducing endoprostheses and drains through gastric and duodenal fistulas, transpapillary, and additionally--in cases when the necrosis was spreading outside of the lesser sac--percutaneously. The results and complications of the endoscopic treatment were assessed retrospectively. RESULTS: Initial success was achieved in 104/112 (92.9%) patients. Long term success was achieved in 94/112 (83.9%) patients in intention to treat analysis and 94/102 (90.4%) patients in per protocol analysis. Recurrence of pancreatic fluid collection was observed in 19/97(19.6%) patients. Procedure-related complications were observed in 29/112 patients (25.9%). Most of them were treated conservatively. Procedure-related mortality was 1.8%. CONCLUSIONS: In a large group of selected patients with symptomatic walled-off necrosis, endoscopic drainage enables high success rate with acceptable complication rate and low procedure-related mortality.
BACKGROUND: Endoscopic drainage of the pancreatic pseudocysts has been accepted as a valid alternative to surgical and percutaneous drainage. Endoscopic treatment of the symptomatic walled-off necrosis was not, however, univocally accepted by all authors. THE AIM: The aim of this study was to assessed the effectiveness and safety of the endoscopic drainage of walled-off necrosis. METHODS AND MATERIAL: Between 2001 and 2011 one hundred and twelve patients with symptomatic walled-off necrosis were treated in the Department of Gastroenterology and Hepatology of the Medical University of Gdansk, using endoscopic drainage. The drainage system was set up by introducing endoprostheses and drains through gastric and duodenal fistulas, transpapillary, and additionally--in cases when the necrosis was spreading outside of the lesser sac--percutaneously. The results and complications of the endoscopic treatment were assessed retrospectively. RESULTS: Initial success was achieved in 104/112 (92.9%) patients. Long term success was achieved in 94/112 (83.9%) patients in intention to treat analysis and 94/102 (90.4%) patients in per protocol analysis. Recurrence of pancreatic fluid collection was observed in 19/97(19.6%) patients. Procedure-related complications were observed in 29/112 patients (25.9%). Most of them were treated conservatively. Procedure-related mortality was 1.8%. CONCLUSIONS: In a large group of selected patients with symptomatic walled-off necrosis, endoscopic drainage enables high success rate with acceptable complication rate and low procedure-related mortality.
Authors: Thomas K Maatman; Alexandra M Roch; Eugene P Ceppa; Jeffrey J Easler; Mark A Gromski; Michael G House; Attila Nakeeb; C Max Schmidt; Stuart Sherman; Nicholas J Zyromski Journal: Surgery Date: 2020-08-22 Impact factor: 3.982
Authors: Mariusz Rosołowski; Michał Lipiński; Marek Dobosz; Marek Durlik; Stanisław Głuszek; Katarzyna Kuśnierz; Paweł Lampe; Ewa Małecka-Panas; Ewa Nowakowska-Duława; Magdalena Nowak-Niezgoda; Barbara Radomańska; Renata Talar-Wojnarowska; Urszula Wereszczyńska-Siemiątkowska; Grażyna Rydzewska Journal: Prz Gastroenterol Date: 2016-06-08