Walled off pancreatic necrosis: Difference between revisions
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'''Walled off pancreatic necrosis''' is complications of | '''Walled off pancreatic necrosis''' is a [[Acute pancreatitis natural history, complications and prognosis|complication of acute pancreatitis]] that usually occurs more than 4 weeks after acute pancreatitis.<ref name="pmid23100216">{{cite journal| author=Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG et al.| title=Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus. | journal=Gut | year= 2013 | volume= 62 | issue= 1 | pages= 102-11 | pmid=23100216 | doi=10.1136/gutjnl-2012-302779 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23100216 }} </ref> | ||
==Treatment== | ==Treatment== | ||
| Line 7: | Line 7: | ||
* minimally invasive surgical necrosectomy | * minimally invasive surgical necrosectomy | ||
* percutaneous catheter drainage | * percutaneous catheter drainage | ||
* endoscopic transgastric drainage | * endoscopic transgastric/transluminal drainage | ||
* direct endoscopic transgastric necrosectomy | * direct endoscopic transgastric/transluminal necrosectomy | ||
* nasocystic drainage | * nasocystic drainage | ||
A | A [[randomized controlled trial]] is underway to compare transluminal endoscopic step-up approach versus minimally invasive surgical step-up approach.<ref name="pmid24274589">{{cite journal| author=van Brunschot S, van Grinsven J, Voermans RP, Bakker OJ, Besselink MG, Boermeester MA et al.| title=Transluminal endoscopic step-up approach versus minimally invasive surgical step-up approach in patients with infected necrotising pancreatitis (TENSION trial): design and rationale of a randomised controlled multicenter trial [ISRCTN09186711]. | journal=BMC Gastroenterol | year= 2013 | volume= 13 | issue= | pages= 161 | pmid=24274589 | doi=10.1186/1471-230X-13-161 | pmc=4222267 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24274589 }} </ref> | ||
==References== | ==References== | ||
<references/> | <references/> | ||
Latest revision as of 20:00, 7 October 2016
Walled off pancreatic necrosis is a complication of acute pancreatitis that usually occurs more than 4 weeks after acute pancreatitis.[1]
Treatment
Options include[2]:
- Lumen-apposing metal stents (LUMS)[3]
- open surgical necrosectomy
- minimally invasive surgical necrosectomy
- percutaneous catheter drainage
- endoscopic transgastric/transluminal drainage
- direct endoscopic transgastric/transluminal necrosectomy
- nasocystic drainage
A randomized controlled trial is underway to compare transluminal endoscopic step-up approach versus minimally invasive surgical step-up approach.[4]
References
- ↑ Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG; et al. (2013). "Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus". Gut. 62 (1): 102–11. doi:10.1136/gutjnl-2012-302779. PMID 23100216.
- ↑ Gurusamy KS, Belgaumkar AP, Haswell A, Pereira SP, Davidson BR (2016). "Interventions for necrotising pancreatitis". Cochrane Database Syst Rev. 4: CD011383. doi:10.1002/14651858.CD011383.pub2. PMID 27083933.
- ↑ Sharaiha RZ, Tyberg A, Khashab MA, Kumta NA, Karia K, Nieto J; et al. (2016). "Endoscopic Therapy With Lumen-apposing Metal Stents Is Safe and Effective for Patients With Pancreatic Walled-off Necrosis". Clin Gastroenterol Hepatol. doi:10.1016/j.cgh.2016.05.011. PMID 27189914.
- ↑ van Brunschot S, van Grinsven J, Voermans RP, Bakker OJ, Besselink MG, Boermeester MA; et al. (2013). "Transluminal endoscopic step-up approach versus minimally invasive surgical step-up approach in patients with infected necrotising pancreatitis (TENSION trial): design and rationale of a randomised controlled multicenter trial [ISRCTN09186711]". BMC Gastroenterol. 13: 161. doi:10.1186/1471-230X-13-161. PMC 4222267. PMID 24274589.