Walled off pancreatic necrosis
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.