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

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.

journal_name

World J Surg

journal_title

World journal of surgery

authors

Ke L,Mao W,Zhou J,Ye B,Li G,Zhang J,Wang P,Tong Z,Windsor J,Li W

doi

10.1007/s00268-018-04878-9

subject

Has Abstract

pub_date

2019-04-01 00:00:00

pages

1121-1128

issue

4

eissn

0364-2313

issn

1432-2323

pii

10.1007/s00268-018-04878-9

journal_volume

43

pub_type

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