Abstract
The surgical treatment of severe acute pancreatitis has significantly changed in the last several years with the advent of enhanced imaging techniques and minimally invasive surgery. Criteria for surgical intervention have been influenced by the use of step-up approaches that provide incremental multimodality interventions with repeat imaging. Here, we provide a brief introduction to the history, goals, indications, and technique of laparoscopic pancreatic necrosectomy. The technique requires a fundamental understanding of the natural history of pancreatitis and its complication. Laparoscopic approaches can be useful as primary and adjunctive therapy for the treatment of infected pancreatitic necrosis.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bradley EL. Management of severe acute pancreatitis: a surgical odyssey. Ann Surg. 2010;251(1):6–17.
Uhl W, Warshaw A, Imrie C et al. IAP Guidelines for the Surgical Management of Acute Pancreatitis. Pancreatology 2002;2:565–573
vanSonnenberg E, Wing VW, Casola G, Coons HG, Nakamoto SK, Mueller PR, Ferrucci JT Jr, Halasz NA, Simeone JF. Temporizing effect of percutaneous drainage of complicated abscesses in critically ill patients. AJR Am J Roentgenol. 1984;142(4):821–6
Freeny PC, Hauptmann E, Althaus SJ, Traverso LW, Sinanan M. Percutaneous CT-guided catheter drainage of infected acute necrotizing pancreatitis: techniques and results. AJR Am J Roentgenol. 1998 Apr;170(4):969–75.
Steiner E, Mueller PR, Hahn PF, Saini S, Simeone JF, Wittenberg J, Warshaw AL, Ferrucci JT Jr. Complicated pancreatic abscesses: problems in interventional management. Radiology. 1988;167(2):443–6.
Zhu JF, Fan XH, Zhang XH. Laparoscopic treatment of severe acute pancreatitis. Surg Endosc. 2001 Feb;15(2):146–8.
Parekh D. Laparoscopic-assisted pancreatic necrosectomy: A new surgical option for treatment of severe necrotizing pancreatitis. Arch Surg. 2006 Sep;141(9):895–902.
Alverdy J, Vargish T, Desai T, Frawley B, Rosen B. Laparoscopic intracavitary debridement of peripancreatic necrosis: preliminary report and description of the technique. Surgery. 2000;127(1):112–4.
Carter CR, McKay CJ, Imrie CW. Percutaneous necrosectomy and sinus tract endoscopy in the management of infected pancreatic necrosis: an initial experience. Ann Surg. 2000; 232:175–180
Horvath KD, Kao LS, Ali A, Wherry KL, Pellegrini CA, Sinanan MN. Laparoscopic assisted percutaneous drainage of infected pancreatic necrosis. Surg Endosc. 2001;15(7):677–82. Epub 2001 May 7
Bucher P, Pugin F, Morel P. Minimally invasive necrosectomy for infected necrotizing pancreatitis. Pancreas. 2008;36(2):113–9.
Babu BI, Siriwardena AK. Current status of minimally invasive necrosectomy for post-inflammatory pancreatic necrosis. HPB (Oxford). 2009;11(2):96–102.
Navaneethan U, Vege SS, Chari ST, Baron TH. Minimally invasive techniques in pancreatic necrosis. Pancreas. 2009;38(8):867–75.
Besselink et al (Dutch Pancreatitis Study Group). Minimally invasive ‘step-up approach’ versus maximal necrosectomy in patients with acute necrotising pancreatitis (PANTER trial): design and rationale of a randomised controlled multicenter trial. BMC Surg. 2006 11;6:6
Rodriguez JR, Razo AO, Targarona J, Thayer SP, Rattner DW, Warshaw AL, Fernández-del Castillo C. Debridement and closed packing for sterile or infected necrotizing pancreatitis: insights into indications and outcomes in 167 patients. Ann Surg. 2008;247(2):294–9
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Fink, D., Soares, R., Matthews, J.B. et al. History, Goals, and Technique of Laparoscopic Pancreatic Necrosectomy. J Gastrointest Surg 15, 1092–1097 (2011). https://doi.org/10.1007/s11605-011-1506-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11605-011-1506-x