Laparoscopy-assisted open cystogastrostomy and pancreatic debridement for necrotizing pancreatitis (with video) View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2015-08-15

AUTHORS

Olivier Gerin, Flavien Prevot, Abdennaceur Dhahri, Sami Hakim, Richard Delcenserie, Lionel Rebibo, Jean-Marc Regimbeau

ABSTRACT

IntroductionPancreatic pseudocysts and walled-off necrosis are well-known complications, described in 10 % of cases of acute pancreatitis. Open cystogastrostomy is usually proposed after failure of minimally invasive drainage or in the presence of septic shock. The objective of this study was to evaluate the feasibility and efficacy of laparoscopy-assisted open cystogastrostomy for treatment of symptomatic pancreatic pseudocyst with pancreatic necrosis. Materials and methodsBetween January 2011 and October 2014, all patients with pseudocyst and pancreatic necrosis undergoing open cystogastrostomy were included. Surgical procedure was standardized. The primary efficacy endpoint was the feasibility and efficacy of laparoscopy-assisted open cystogastrostomy as treatment of symptomatic pancreatic pseudocyst. Secondary endpoints included demographic data, preoperative management, operative data, postoperative data and follow-up.ResultsLaparoscopy-assisted open cystogastrostomy was performed in 11 patients [six men (54 %)], with a median age of 61 years (45–84). Nine patients received preoperative radiological or endoscopic management. First-line open cystogastrostomy was performed in two cases. Median operating time was 190 min (110–240). There was one intraoperative complication related to injury of a branch of the superior mesenteric vein. There were no postoperative deaths and two postoperative complications (18 %) including one major complication (postoperative bleeding). The median length of hospital stay after surgery was 16 days (7–35). The median follow-up was 10 months (2–45). One patient experienced recurrence during follow-up.ConclusionOpen cystogastrostomy for necrotizing pancreatitis promotes adequate internal drainage with few postoperative complications and a short length of hospital stay. However, this technique must be performed very cautiously due to the risk of vascular injury which can be difficult to repair in the context of severe local inflammation related to pancreatic necrosis. More... »

PAGES

1235-1241

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00464-015-4331-6

DOI

http://dx.doi.org/10.1007/s00464-015-4331-6

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1002533506

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/26275532


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