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

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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.

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Funding

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

Author information

Author notes

  1. Lu Ke, Wenjian Mao and Jing Zhou have contributed equally to this work.

Authors and Affiliations

  1. Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 Zhongshan East Road, Nanjing, 210002, Nanjing Province, China

    Lu Ke, Wenjian Mao, Jing Zhou, Bo Ye, Gang Li, Jingzhu Zhang, Peng Wang, Zhihui Tong & Weiqin Li

  2. Department of General Surgery, Jinling Clinical Medical College of Southern Medical University, No. 305 Zhongshan East Road, Nanjing, China

    Wenjian Mao & Peng Wang

  3. Department of Surgery, University of Auckland, Auckland, New Zealand

    John Windsor

Authors
  1. Lu Ke
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  2. Wenjian Mao
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  3. Jing Zhou
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  4. Bo Ye
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  5. Gang Li
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  6. Jingzhu Zhang
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  7. Peng Wang
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  8. Zhihui Tong
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  9. John Windsor
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  10. Weiqin Li
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Corresponding authors

Correspondence to Zhihui Tong or Weiqin Li.

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Ke, L., Mao, W., Zhou, J. et al. Stent-Assisted Percutaneous Endoscopic Necrosectomy for Infected Pancreatic Necrosis: Technical Report and a Pilot Study. World J Surg 43, 1121–1128 (2019). https://doi.org/10.1007/s00268-018-04878-9

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  • DOI: https://doi.org/10.1007/s00268-018-04878-9

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