Analysis of risk factors for minimally invasive pancreatic necrosectomy combined with bleeding and endoscopic hemostasis in acute necrotizing pancreatitis: a real-world study

Pancreatology ◽  
2020 ◽  
Vol 20 ◽  
pp. S35
Author(s):  
X. Zheng ◽  
L. Li ◽  
J. Li ◽  
X. Huang ◽  
Y. Lei ◽  
...  
Keyword(s):  
Risk Factors ◽  
Minimally Invasive ◽  
Real World ◽  
Necrotizing Pancreatitis ◽  
Acute Necrotizing Pancreatitis ◽  
Endoscopic Hemostasis ◽  
Pancreatic Necrosectomy ◽  
Acute Necrotizing

scholarly journals ARROSIVE BLEEDING WITH PANCREATIC NECROSIS — TACTICAL APPROACHES

2020 ◽  
pp. 85-88 ◽  
Author(s):  
V. V. Mishchenko ◽  
P. I. Pustovoit ◽  
R. Yu. Vododyuk ◽  
V. V. Velichko ◽  
V. V. Goryachy
Keyword(s):  
Minimally Invasive ◽  
Pancreatic Necrosis ◽  
Necrotizing Pancreatitis ◽  
Acute Necrotizing Pancreatitis ◽  
Stent Grafts ◽  
Invasive Treatment ◽  
Results Of Treatment ◽  
Hemorrhagic Complications ◽  
Necrotic Pancreatitis ◽  
Acute Necrotizing

Summary. The problem of hemorrhagic complications of destructive pancreatitis is relevant. The aim of the study was to study the frequency and sources of hemorrhagic complications in patients with pancreatic necrosis, to evaluate the tactics of diagnosis and the effectiveness of methods to stop bleeding. Materials and methods. A study of the results of treatment of 40 patients with acute necrotizing pancreatitis was conducted. Results and its discussion. In 67.5 % of patients with acute necrotizing pancreatitis, hemorrhagic complications in the form of arrosive bleeding were observed. A method of endovascular occlusion of vessels using Gianturco spirals or stent grafts to stop arrosive bleeding in acute necrotizing pancreatitis has been introduced in the clinic. In 37.0 % of cases, repeated signs of arrosive bleeding were observed. In acute necrotizing pancreatitis complicated by arrosive bleeding, mortality was 44.4 %. Conclusions. The main cause of hemorrhagic complications in acute necrotic pancreatitis is acute necrotic changes, during infection of which arrosia of adjacent vessels occurs. The predominant tactic in case of bleeding from the retroperitoneal space against the background of minimally invasive treatment is clamping of drains, endovascular hemostasis using Gianturco spirals or stent grafts and the use of hemostatic soluble gauze (hemostop). Mortality in the development of arrosive bleeding in acute necrotic pancreatitis is 44.4 %.

Initial minimally invasive retroperitoneal necrosectomy for acute necrotizing pancreatitis

2015 ◽  
Vol 2 (4) ◽  
Author(s):  
Audrius Sileikis ◽  
Gintare Kavaliauskaite ◽  
Viktorija Zukauskiene ◽  
Kestutis Strupas
Keyword(s):  
Minimally Invasive ◽  
Necrotizing Pancreatitis ◽  
Acute Necrotizing Pancreatitis ◽  
Acute Necrotizing

scholarly journals Various Endoscopic Techniques for Treatment of Consequences of Acute Necrotizing Pancreatitis: Practical Updates for the Endoscopist

2020 ◽  
Vol 9 (1) ◽  
pp. 117
Author(s):  
Mateusz Jagielski ◽  
Marian Smoczyński ◽  
Jacek Szeliga ◽  
Krystian Adrych ◽  
Marek Jackowski
Keyword(s):  
Minimally Invasive ◽  
Pancreatic Necrosis ◽  
Necrotizing Pancreatitis ◽  
Acute Necrotizing Pancreatitis ◽  
Minimally Invasive Treatment ◽  
Interventional Treatment ◽  
Endoscopic Drainage ◽  
Invasive Treatment ◽  
Endoscopic Techniques ◽  
Acute Necrotizing

Despite great progress in acute pancreatitis (AP) treatment over the last 30 years, treatment of the consequences of acute necrotizing pancreatitis (ANP) remains controversial. While numerous reports on minimally invasive treatment of the consequences of ANP have been published, several aspects of interventional treatment, particularly endoscopy, are still unclear. In this article, we attempt to discuss these aspects and summarize the current knowledge on endoscopic therapy for pancreatic necrosis. Endotherapy has been shown to be a safe and effective minimally invasive treatment modality in patients with consequences of ANP. The evolution of endoscopic techniques has made endoscopic drainage more effective and reduced the use of other minimally invasive therapies for pancreatic necrosis.

scholarly journals Risk Factors For Development Of Acute Necrotizing Pancreatitis

2015 ◽  
Vol 16 (2) ◽  
pp. 121-127
Author(s):  
Bojan Stojanovic ◽  
Marko Spasic ◽  
Ivan Radosavljevic ◽  
Dragan Canovic ◽  
Dragce Radovanovic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Pancreatitis ◽  
Initial Treatment ◽  
Positive Impact ◽  
Necrotizing Pancreatitis ◽  
Acute Necrotizing Pancreatitis ◽  
Surgical Intensive Care Unit ◽  
High Morbidity ◽  
Surgical Intensive Care ◽  
Acute Necrotizing

Abstract Acute necrotizing pancreatitis (ANP) is a severe form of acute pancreatitis that is associated with high morbidity and mortality. Thus, an adequate initial treatment of patients who present with acute pancreatitis (AP) based on correct interpretation of early detected laboratory and clinical abnormalities may have a significant positive impact on the disease course. The aim of the study was to determine patient- and initial treatment-related risk factors for the development of acute necrotizing pancreatitis. For the purpose of this study a case-control design was chosen, including adult patients treated for AP in the surgical Intensive Care Unit (sICU) of Clinical Center of Kragujevac, from January 2006 to January 2011. The cases (n=63) were patients who developed ANP, while the controls (n=63) were patients with AP without the presence of pancreatic necrosis. The controls were randomly selected from a study sample after matching with the cases by age and sex. Significant association with the development of ANP was found for the presence of comorbidity (adjusted OR 6.614 95%CI 1.185-36.963), and the use of somatostatin (adjusted OR 7.460, 95%CI 1.162-47.833) and furosemide (adjusted OR 2710.57, 95%CI 1.996-56.035) started immediately upon admission to the sICU. This study suggests that comorbidities, particularly the presence of serious cardio-vascular disease, can increase the risk for development of acute necrotizing pancreatitis. The probability for the development of ANP could be reduced by the avoidance of the initial use of loop diuretics and somatostatin.

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