Surgical Transgastric Necrosectomy for Necrotizing Pancreatitis: A Single-stage Procedure for Walled-off Pancreatic Necrosis.

Annals of Surgery
Michael DriedgerChad G Ball

Abstract

The aim of this study was to evaluate the role of surgical transgastric necrosectomy (TGN) for walled-off pancreatic necrosis (WON) in selected patients. WON is a common consequence of severe pancreatitis and typically occurs 3 to 5 weeks after the onset of acute pancreatitis. When symptomatic, it can require intervention. A retrospective review of patients with WON undergoing surgical management at 3 high-volume pancreatic institutions was performed. Surgical indications, intervention timing, technical methodology, and patient outcomes were evaluated. Patients undergoing intervention <30 days were excluded. Differences across centers were evaluated using a P value of <0.05 as significant. One hundred seventy-eight total patients were analyzed (mean WON diameter = 14 cm, 64% male, mean age = 51 years) across 3 centers. The majority required inpatient admission with a median preoperative length of hospital stay of 29 days (25% required preoperative critical care support). Most (96%) patients underwent a TGN. The median duration of time between the onset of pancreatitis symptoms and operative intervention was 60 days. Thirty-nine percent of the necrosum was infected. Postoperative morbidity and mortality were 38% and 2%, respecti...Continue Reading

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Citations

Feb 23, 2019·Expert Review of Gastroenterology & Hepatology·Surinder Singh Rana
Mar 5, 2020·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Thomas K Maatman, Nicholas J Zyromski
Sep 11, 2020·Langenbeck's Archives of Surgery·Max HecklerJohn P Neoptolemos
Mar 19, 2020·World Journal of Emergency Surgery : WJES·Henrik Leonard HusuPanu Juhani Mentula
Sep 29, 2019·World Journal of Clinical Cases·Tomohide HoriMasazumi Zaima
Oct 22, 2020·The New England Journal of Medicine·Mariko R YasudaMai P Hoang
Dec 4, 2020·Revista Española De Enfermedades Digestivas : Organo Oficial De La Sociedad Española De Patología Digestiva·Qi-Chen CaiBin Xiong
Aug 15, 2021·Advances in Surgery·Amy Y LiBrendan C Visser
Jul 10, 2021·Annals of Surgery·Thomas K MaatmanNicholas J Zyromski
Dec 3, 2021·Journal of Hepato-biliary-pancreatic Sciences·Gemma VellaltaOriol Puig

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