Management of Infected Pancreatic Necrosis—The “Step Up” Approach and Minimal Access Retroperitoneal Pancreatic Necrosectomy
Case Report
First Online:
Received:
Accepted:
- 156 Downloads
Abstract
Infected pancreatic necrosis (IPN) is associated with high morbidity and mortality. It is increasingly being recognized that noninvasive management, radiological guided drainage, and minimally invasive procedures rather than the traditionally advocated open necrosectomy are associated with a better outcome in IPN. We present a patient with IPN who was managed with the now popular “step up” approach and describe the procedure of Minimal access retroperitoneal pancreatic necrosectomy.
Keywords
Pancreatic necrosis Infection Necrosectomy Step up approachReferences
- 1.Da Costa DW, Boerma D, van Santvoort HC, Horvath KD et al (2014) Staged multidisciplinary step-up management for necrotizing pancreatitis. Br J Surg 101:e65–e79CrossRefPubMedGoogle Scholar
- 2.Flint RS, Windsor JA (2003) The role of the intestine in pathophysiology and management of severe acute pancreatitis. HPB 5(2):69–85CrossRefPubMedCentralPubMedGoogle Scholar
- 3.Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG et al (2013) Pancreatitis Classification Working Group. Classification of acute pancreatitis—2012: revision of the Atlanta classification and definitions by international consensus. Gut 62:102–111CrossRefPubMedGoogle Scholar
- 4.Sing VK, Wu BU, Bollen TL, Repas K et al (2009) Early systemic inflammatory response syndrome is associated with severe acute pancreatitis. Clin Gastroenterol Hepatol 7:1247–1251CrossRefGoogle Scholar
- 5.Easler JJ, Zureikat A, Papachristou GI (2012) An update on minimally invasive therapies for pancreatic necrosis. Expert Rev Gastroenterol Hepatol 6(6):745–753CrossRefPubMedGoogle Scholar
- 6.Van Santvoort HC, Besselink MG, Bakker OJ, Hofker HS et al (2010) A step-up approach or open necrosectomy for necrotizing pancreatitis. NEJM 362:16CrossRefGoogle Scholar
- 7.Van Brunschot S, van Grinsven J, Voermans RP, Bakker OJ et al (2013) Transluminal endoscopic step-up approach versus minimally invasive surgical step-up approach in patients with infected necrotizing pancreatitis (TENSION trial): design and rationale of a randomized controlled multicenter trial [ISRCTN09786711]. BMC Gastroenterol 13:161CrossRefPubMedCentralPubMedGoogle Scholar
Copyright information
© Association of Surgeons of India 2014