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        Pancreatic Necrosectomy through Sinus Tract Endoscopy

        Mahesh Kumar Goenka,Usha Goenka,Md.Yasin Mujoo,Indrajit Kumar Tiwary,Sanjay Mahawar,Vijay Kumar Rai 대한소화기내시경학회 2018 Clinical Endoscopy Vol.51 No.3

        Background/Aims: Direct endoscopic pancreatic necrosectomy is increasingly being utilized to treat infected or symptomatic walledoffnecrosis (WON) located close to the stomach or duodenum. Laterally-placed WON has traditionally been treated surgically. Weevaluated a less utilized technique of sinus tract endoscopy (STE) for symptomatic laterally-placed WON. Methods: Two hundred seventy-six patients with acute pancreatitis admitted in our hospital, 32 had symptomatic or infected WONrequiring intervention. Of the 12 patients with laterally placed WON, 10 were treated by STE. STE was performed with a standard adultgastroscope passed through a percutaneous tract created by the placement of a 32-Fr drain. Results: Ten patients (7 males; mean age, 43.8 years) underwent STE. Mean number of sessions was 2.3 (range, 1–4), with mean timeof 70 minutes for each session (range, 15–70 minutes). While 9 patients had complete success, 1 patient had fever and chose to undergosurgery. Two patients developed pneumoperitoneum, which was treated conservatively. There was no mortality, cutaneous fistula, orrecurrence during follow-up. Conclusions: Laterally placed WON can be successfully managed by STE performed through a percutaneously placed drain. Details ofthe technique and end-points of STE require further evaluation.

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