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Laparoscopic necrosectomy for acute necrotising pancreatitis: Retrospective analysis of a decade-long experience from a tertiary centre.
Sivakumar, Srivatsan Gurumurthy; Sekaran, Monika; Muthukrishnan, Srinivasan; Natesan, Anand Vijai; Nalankilli, V P; Senthilnathan, Palanisamy; Palanivelu, Chinnusamy.
Afiliación
  • Sivakumar SG; Department of HPB, Minimal Access Surgery and Liver Transplant, Gem Hospital, Chennai, Tamil Nadu, India.
J Minim Access Surg ; 20(2): 127-135, 2024 Apr 01.
Article en En | MEDLINE | ID: mdl-38557646
ABSTRACT

INTRODUCTION:

The objective of this study is to evaluate the role of minimally invasive surgery for the management of necrotising pancreatitis in acute settings and to propose tailor-made approaches to deal with various locations of pancreatic necrosis. PATIENTS AND

METHODS:

Three hundred and thirteen patients underwent laparoscopic management of necrotising pancreatitis in this study period from January 2010 to June 2021, out of which 122 patients underwent minimally invasive necrosectomy for acute necrotising pancreatitis. The remaining 191 patients underwent laparoscopic internal drainage in the form of cystogastrostomy/cystojejunostomy for walled-off pancreatic necrosis.

RESULTS:

Mean body mass index was 26.45 ± 3.78 kg/sqm. Mean operating time was 56.40 ± 20.48 min and mean blood loss was 120 ± 31.45 mL. Ten patients required reoperation (6 underwent open procedure and 4 underwent laparoscopic redo necrosectomy). Six patients died of multi-organ failure. The mean duration of return of bowel function was 5 ± 1.8 days. The mean length of hospital stay after surgery was 10.19 ± 7.09 days. There were no major wound-related complications.

CONCLUSION:

A minimally invasive approach to pancreatic necrosectomy is safe and feasible with good outcomes in centres with advanced laparoscopic expertise. It requires not only careful case selection but also proper timing and the ideal route of access to achieve optimal outcomes.

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Minim Access Surg Año: 2024 Tipo del documento: Article País de afiliación: India Pais de publicación: India

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Minim Access Surg Año: 2024 Tipo del documento: Article País de afiliación: India Pais de publicación: India