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Stent-Assisted Percutaneous Endoscopic Necrosectomy for Infected Pancreatic Necrosis: Technical Report and a Pilot Study

  • Lu Ke
  • Wenjian Mao
  • Jing Zhou
  • Bo Ye
  • Gang Li
  • Jingzhu Zhang
  • Peng Wang
  • Zhihui TongEmail author
  • John Windsor
  • Weiqin LiEmail author
Original Scientific Report with Video

Abstract

Background and aims

A variety of minimally invasive techniques have been proposed to replace open surgery for the treatment of infected pancreatic necrosis (IPN). In this study, we evaluate the feasibility and safety of the stent-assisted percutaneous endoscopic necrosectomy (SAPEN) procedure.

Methods

Data were collected on all patients who underwent the SAPEN procedure between October 2017 and March 2018. The demographic and clinical characteristics of the study patients were analyzed. A composite primary endpoint of major complications and/or death was used. Three different cases were selected to illustrate different technical aspects of the SAPEN procedure.

Results

The placement of a percutaneous stent was successful in all of the 23 patients (17 males, six females). IPN was successfully managed in 16/23 (70%) patients, with the need for open surgery in seven patients (30%), with a median of two (range 1–5) SAPEN procedures. No significant procedure-related complications occurred. Overall 11/23 (48%) patients had a major complication and/or death.

Conclusions

In conclusion, the SAPEN procedure was effective in treating IPN without adding extra procedural risk. The role and benefits of the SAPEN procedure now need to be demonstrated in larger controlled study.

Notes

Funding

This study was supported by the National Science Foundation of China No. 81770641.

Supplementary material

268_2018_4878_MOESM1_ESM.avi (11.6 mb)
Supplementary material 1 (AVI 11835 kb)

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Copyright information

© Société Internationale de Chirurgie 2018

Authors and Affiliations

  • Lu Ke
    • 1
  • Wenjian Mao
    • 1
    • 2
  • Jing Zhou
    • 1
  • Bo Ye
    • 1
  • Gang Li
    • 1
  • Jingzhu Zhang
    • 1
  • Peng Wang
    • 1
    • 2
  • Zhihui Tong
    • 1
    Email author
  • John Windsor
    • 3
  • Weiqin Li
    • 1
    Email author
  1. 1.Department of General Surgery, Jinling HospitalMedical School of Nanjing UniversityNanjingChina
  2. 2.Department of General SurgeryJinling Clinical Medical College of Southern Medical UniversityNanjingChina
  3. 3.Department of SurgeryUniversity of AucklandAucklandNew Zealand

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