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NOTES Pancreatic Debridement

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NOTES and Endoluminal Surgery

Part of the book series: Clinical Gastroenterology ((CG))

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Abstract

Recent refinements in the nomenclature have attempted to simplify previous classification schemes regarding acute pancreatitis and its sequelae. Our understanding of the natural history of acute pancreatitis and its sequelae continues to evolve. A subset of patients with acute pancreatitis develops peripancreatic collections that, over time, may evolve into walled-off necrosis (WON). The currently available literature suggests that endoscopic management of WON is the preferred management strategy in the majority of cases. Treatment strategies range from simple drainage of liquefied contents to repeated direct endoscopic necrosectomy (DEN) of a complex necrotic collection, with each method requiring a variety of techniques and tools necessary to achieve success. In this chapter, we focus on the indications, techniques, and outcomes for endoscopic therapy of WON.

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Abbreviations

WON:

Walled-off necrosis

CT:

Computed tomography

DEN:

Direct endoscopic necrosectomy

FNA:

Fine needle aspiration

EUS:

Endoscopic ultrasound

SEMS:

Self-expandable metal stent

LAMS:

Lumen-apposing metal stent

ERCP:

Endoscopic retrograde cholangiopancreatography

VARD:

Video-assisted retroperitoneal debridement

TTS:

Through-the-scope

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Author Contributions

Ryan Law, DO, prepared the draft of the manuscript and approved the final manuscript.

Todd H. Baron, MD, provided the conception of article, conducted a critical review, and approved the final manuscript.

Conflict of Interest

Ryan Law, DO, has no conflict of interest.

Todd H. Baron, MD: W.L. Gore, Boston Scientific, Olympus, Cook Endoscopy.

Author information

Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, USA

    Ryan Law

  2. Division of Gastroenterology and Hepatology, University of North Carolina, 41041 Bioinformatics Blvd, CB 7080, Chapel Hill, NC, 27599-0001, USA

    Todd H. Baron

Authors
  1. Ryan Law
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Corresponding author

Correspondence to Todd H. Baron .

Editor information

Editors and Affiliations

  1. Department of Surgery, University of Massachusetts / Baystate Medical Center, Springfield, Massachusetts, USA

    John R. Romanelli

  2. Division of Gastroenterology, University of Massachusetts / Baystate Medical Center, Springfield, Massachusetts, USA

    David J. Desilets

  3. Lowell Surgical Associates , North Chelmsford, Massachusetts, USA

    David B. Earle

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Law, R., Baron, T.H. (2017). NOTES Pancreatic Debridement. In: Romanelli, J., Desilets, D., Earle, D. (eds) NOTES and Endoluminal Surgery. Clinical Gastroenterology. Springer, Cham. https://doi.org/10.1007/978-3-319-50610-4_12

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  • DOI: https://doi.org/10.1007/978-3-319-50610-4_12

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-50608-1

  • Online ISBN: 978-3-319-50610-4

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