skip to main content
Idioma:
Primo Search
Clear Search Box
Search in: Busca Geral
Busca Avançada
Busca por Índices
Tipo de recurso Mostra resultados com: Mostra resultados com: Índice

Percutaneous Endoscopic Step-Up Therapy Is an Effective Minimally Invasive Approach for Infected Necrotizing Pancreatitis

Jain, Saransh ; Padhan, Rajesh ; Bopanna, Sawan ; Jain, Sushil Kumar ; Dhingra, Rajan ; Dash, Nihar Ranjan ; Madhusudan, Kumble Seetharama ; Gamanagatti, Shivanand Ramachandra ; Sahni, Peush ; Garg, Pramod Kumar

Digestive diseases and sciences, 2020-02, Vol.65 (2), p.615-622 [Periódico revisado por pares]

New York: Springer US

Texto completo disponível

Citações Citado por
  • Título:
    Percutaneous Endoscopic Step-Up Therapy Is an Effective Minimally Invasive Approach for Infected Necrotizing Pancreatitis
  • Autor: Jain, Saransh ; Padhan, Rajesh ; Bopanna, Sawan ; Jain, Sushil Kumar ; Dhingra, Rajan ; Dash, Nihar Ranjan ; Madhusudan, Kumble Seetharama ; Gamanagatti, Shivanand Ramachandra ; Sahni, Peush ; Garg, Pramod Kumar
  • Assuntos: Antibiotics ; Biochemistry ; Care and treatment ; Endoscopy ; Gangrene ; Gastroenterology ; Health aspects ; Hepatology ; Medical research ; Medicine ; Medicine & Public Health ; Medicine, Experimental ; Mortality ; Oncology ; Original Article ; Pancreatitis ; Surgery ; Transplant Surgery
  • É parte de: Digestive diseases and sciences, 2020-02, Vol.65 (2), p.615-622
  • Notas: SourceType-Scholarly Journals-1
    ObjectType-Feature-4
    ObjectType-Undefined-1
    content type line 23
    ObjectType-Undefined-2
    ObjectType-Article-3
  • Descrição: Background Infected pancreatic necrosis (IPN) is a major complication of acute pancreatitis (AP), which may require necrosectomy. Minimally invasive surgical step-up therapy is preferred for IPN. Aim To assess the effectiveness of percutaneous endoscopic step-up therapy in patients with IPN and identify predictors of its success. Methods Consecutive patients with AP hospitalized to our tertiary care academic center were studied prospectively. Patients with IPN formed the study group. The treatment protocol for IPN was percutaneous endoscopic step-up approach starting with antibiotics and percutaneous catheter drainage, and if required necrosectomy. Percutaneous endoscopic necrosectomy (PEN) was performed using a flexible endoscope through the percutaneous tract under conscious sedation. Control of sepsis with resolution of collection(s) was the primary outcome measure. Results A total of 415 patients with AP were included. Of them, 272 patients had necrotizing pancreatitis and 177 (65%) developed IPN. Of these 177 patients, 27 were treated conservatively with antibiotics alone, 56 underwent percutaneous drainage alone, 53 required underwent PEN as a step-up therapy, 1 per-oral endoscopic necrosectomy, and 52 required surgery. Of the 53 patients in the PEN group, 42 (79.2%) were treated successfully—34 after PEN alone and 8 after additional surgery. Eleven of 53 patients died due to organ failure—7 after PEN and 4 after surgery. Independent predictors of mortality were > 50% necrosis and early organ failure. Conclusion Percutaneous endoscopic step-up therapy is an effective strategy for IPN. Organ failure and extensive pancreatic necrosis predicted a suboptimal outcome in patients with infected necrotizing pancreatitis.
  • Editor: New York: Springer US
  • Idioma: Inglês
Links
Voltar para lista de resultados

  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

Buscando em bases de dados remotas. Favor aguardar.