Surgical Endoscopy

, Volume 25, Issue 12, pp 3724–3730 | Cite as

Endoscopic necrosectomy of pancreatic necrosis: a systematic review

  • Alireza Haghshenasskashani
  • Jerome M. Laurence
  • Vu Kwan
  • Emma Johnston
  • Michael J. Hollands
  • Arthur J. Richardson
  • Henry C. C. Pleass
  • Vincent W. T. Lam
Review

Abstract

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 were excluded.

Results

Indications, techniques and outcomes of endoscopic necrosectomy were analysed. There were no randomised controlled trials identified. Ten case series were included in this analysis. There were a total of more than 1,100 endoscopic necrosectomy procedures in 260 patients with pancreatic necrosis. One hundred fifty-five were proven to be infected necrosis on culture. The overall mortality rate was 5%. The mean procedure-related morbidity rate was 27%. The rate of complete resolution of pancreatic necrosis with the endoscopic method alone was 76%.

Conclusions

Endoscopic necrosectomy is a safe and effective treatment option in selected patients with pancreatic necrosis after acute pancreatitis. Future studies will be required to further define the selection criteria and the techniques for the endoscopic procedure.

Keywords

Abdominal Pancreatic G-I < Endoscopy Intensive care General < Technical Clinical papers/trials/research 

Notes

Disclosure

Authors Alireza Haghshenasskashani, Jerome M. Laurence, Vu Kwan, Emma Johnston, Michael J. Hollands, Arthur J. Richardson, Henry C. C. Pleass and Vincent W. T. Lam have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Alireza Haghshenasskashani
    • 1
  • Jerome M. Laurence
    • 1
    • 3
  • Vu Kwan
    • 2
  • Emma Johnston
    • 1
  • Michael J. Hollands
    • 1
  • Arthur J. Richardson
    • 1
  • Henry C. C. Pleass
    • 1
    • 3
  • Vincent W. T. Lam
    • 1
    • 3
  1. 1.Department of SurgeryWestmead HospitalWentworthville, SydneyAustralia
  2. 2.Department of Gastroenterology and HepatologyWestmead HospitalSydneyAustralia
  3. 3.Discipline of SurgeryUniversity of SydneySydneyAustralia

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