The surgical approach to acute necrotizing pancreatitis treatment

The aim of this work was to estimate the efficiency of the proposed surgical treatment for acute necrotizing pancreatitis. Materials and Methods: We analyzed the outcomes of the treatment of 317 patients with acute necrotizing pancreatitis in whom the proposed surgical treatment was used over the period of 2013-2019. The new postoperative onset of organ failure, duration of intensive care treatment, postoperative complications, and mortality rates was studied. Results and Discussion: We used the step-up approach to surgical treatment, which started from either diapeutic transcutaneous ultrasound-guided procedures in 48.2 % and endoscopic ultrasound-guided - in 46.2 % of cases. Transcutaneous procedures were followed by less complication rate in acute necrotic collection cases whereas endoscopic operations - in walled-off pancreatic necrosis patients. Wide laparotomic necrosectomies were applied in 14.5 % of patients after the 4th week of the disease onset. The overall mortality rate was 3.5 %, and after the surgical treatment - 6.5 %. Application of step-up surgical treatment in patients with ANP decreases the need to perform wide laparotomic necrosectomies and reduces the rate of postoperative complications.

Authors
Klimov A.E. , Samara M. , Persov M.Y. , Kirtadze D.G. , Barhudarov A.A.
Publisher
WOLTERS KLUWER MEDKNOW PUBLICATIONS
Number of issue
1
Language
English
Pages
140-142
Status
Published
Volume
11
Year
2020
Keywords
Acute necrotizing pancreatitis; minimally invasive treatment; echo-video endoscopy; multimodal step-up approach
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