Literature DB >> 26271525

Routine use of U-tube drainage for necrotizing pancreatitis: a step toward less morbidity and resource utilization.

Christopher C Stahl1, Jonathan Moulton2, Doan Vu2, Ross Ristagno2, Kyuran Choe2, Jeffrey J Sussman1, Shimul A Shah1, Syed A Ahmad1, Daniel E Abbott3.   

Abstract

BACKGROUND: A U-tube drainage catheter (UTDC) is a novel intervention for necrotizing pancreatitis, with multiple benefits: bidirectional flushing, greater interface with large fluid collections, less risk of dislodgement, and creation of a large-diameter fistula tract for potential fistulojejunostomy. We report the first clinical experience with UTDC for necrotizing pancreatitis.
METHODS: From 2011 to 2014, all patients undergoing UTDC for necrotizing pancreatitis at our institution were identified. Clinical variables including patient, disease, and intervention-specific characteristics as well as long-term outcomes populated our dataset.
RESULTS: Twenty-two patients underwent UTDC for necrotizing pancreatitis; the median follow-up was 10.2 months. Necrotizing pancreatitis was most commonly owing to gallstones (n = 9; 41%), idiopathic disease (n = 5; 23%), and alcohol abuse (n = 4; 18%). During the course of UTDC and definitive operative therapy (when required), patients had median hospital stays of 31 days, 6 interventional radiology procedures, and 6 CT scans. Operative intervention was not necessary in 9 patients (41%). Among the other 13 patients, 4 patients underwent distal pancreatectomy/splenectomy, 8 had a fistulojejunostomy performed, and 1 underwent both procedures.
CONCLUSION: UTDC for necrotizing pancreatitis patients is associated with effective drainage and low morbidity/hospital resource utilization. With skilled interventional radiologists and multidisciplinary coordination, this technique is a valuable means of minimizing morbidity for patients with necrotizing pancreatitis.
Copyright © 2015 Elsevier Inc. All rights reserved.

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Year:  2015        PMID: 26271525      PMCID: PMC7046079          DOI: 10.1016/j.surg.2015.07.006

Source DB:  PubMed          Journal:  Surgery        ISSN: 0039-6060            Impact factor:   3.982


  26 in total

1.  Surgical treatment for severe acute pancreatitis: extent and surgical control of necrosis determine outcome.

Authors:  Peter Götzinger; Thomas Sautner; Stephan Kriwanek; Philipp Beckerhinn; Murat Barlan; Christian Armbruster; Peter Wamser; Reinhold Függer
Journal:  World J Surg       Date:  2002-02-06       Impact factor: 3.352

2.  The many uses of the U tube.

Authors:  J S Thompson; D A Burnett; P E Hodgson
Journal:  Am J Surg       Date:  1986-12       Impact factor: 2.565

3.  Minimal access retroperitoneal pancreatic necrosectomy: improvement in morbidity and mortality with a less invasive approach.

Authors:  Michael G T Raraty; Christopher M Halloran; Susanna Dodd; Paula Ghaneh; Saxon Connor; Jonathan Evans; Robert Sutton; John P Neoptolemos
Journal:  Ann Surg       Date:  2010-05       Impact factor: 12.969

4.  A conservative and minimally invasive approach to necrotizing pancreatitis improves outcome.

Authors:  Hjalmar C van Santvoort; Olaf J Bakker; Thomas L Bollen; Marc G Besselink; Usama Ahmed Ali; A Marjolein Schrijver; Marja A Boermeester; Harry van Goor; Cornelis H Dejong; Casper H van Eijck; Bert van Ramshorst; Alexander F Schaapherder; Erwin van der Harst; Sijbrand Hofker; Vincent B Nieuwenhuijs; Menno A Brink; Philip M Kruyt; Eric R Manusama; George P van der Schelling; Tom Karsten; Eric J Hesselink; Cornelis J van Laarhoven; Camiel Rosman; Koop Bosscha; Ralph J de Wit; Alexander P Houdijk; Miguel A Cuesta; Peter J Wahab; Hein G Gooszen
Journal:  Gastroenterology       Date:  2011-07-08       Impact factor: 22.682

5.  Management of necrotizing pancreatitis: flexible approach depending on intra-operative assessment of necrosis.

Authors:  M Olakowski; D Dranka-Bojarowska; E Szlachta-Swiatkowska; A Lekstan; P Lampe
Journal:  Acta Chir Belg       Date:  2006 Mar-Apr       Impact factor: 1.090

6.  Open pancreatic necrosectomy in the multidisciplinary management of postinflammatory necrosis.

Authors:  Benoy I Babu; Aali J Sheen; Stephen H Lee; Sarah O'Shea; Jane M Eddleston; Ajith K Siriwardena
Journal:  Ann Surg       Date:  2010-05       Impact factor: 12.969

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

Authors:  Hjalmar C van Santvoort; Marc G Besselink; Olaf J Bakker; H Sijbrand Hofker; Marja A Boermeester; Cornelis H Dejong; Harry van Goor; Alexander F Schaapherder; Casper H van Eijck; Thomas L Bollen; Bert van Ramshorst; Vincent B Nieuwenhuijs; Robin Timmer; Johan S Laméris; Philip M Kruyt; Eric R Manusama; Erwin van der Harst; George P van der Schelling; Tom Karsten; Eric J Hesselink; Cornelis J van Laarhoven; Camiel Rosman; Koop Bosscha; Ralph J de Wit; Alexander P Houdijk; Maarten S van Leeuwen; Erik Buskens; Hein G Gooszen
Journal:  N Engl J Med       Date:  2010-04-22       Impact factor: 91.245

8.  Focused open necrosectomy in necrotizing pancreatitis.

Authors:  Guntars Pupelis; Vladimir Fokin; Kaspars Zeiza; Haralds Plaudis; Anastasija Suhova; Nadezda Drozdova; Viesturs Boka
Journal:  HPB (Oxford)       Date:  2012-11-22       Impact factor: 3.647

9.  Fistulojejunostomy for the management of refractory pancreatic fistula.

Authors:  Rajalakshmi R Nair; Andrew M Lowy; Benjamin McIntyre; Jeffrey J Sussman; Jeffrey B Matthews; Syed A Ahmad
Journal:  Surgery       Date:  2007-10       Impact factor: 3.982

Review 10.  Staged multidisciplinary step-up management for necrotizing pancreatitis.

Authors:  D W da Costa; D Boerma; H C van Santvoort; K D Horvath; J Werner; C R Carter; T L Bollen; H G Gooszen; M G Besselink; O J Bakker
Journal:  Br J Surg       Date:  2013-11-22       Impact factor: 6.939

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  1 in total

1.  Fistulojejunostomy Versus Distal Pancreatectomy for the Management of the Disconnected Pancreas Remnant Following Necrotizing Pancreatitis.

Authors:  Vikrom K Dhar; Jeffrey M Sutton; Brent T Xia; Nick C Levinsky; Gregory C Wilson; Milton Smith; Kyuran A Choe; Jonathan Moulton; Doan Vu; Ross Ristagno; Jeffrey J Sussman; Michael J Edwards; Daniel E Abbott; Syed A Ahmad
Journal:  J Gastrointest Surg       Date:  2017-04-10       Impact factor: 3.452

  1 in total

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