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Remizov S.I.

Regional Clinical Hospital No. 2;
Kuban State Medical University

Andreev A.V.

Regional Clinical Hospital No. 2;
Kuban State Medical University

Durleshter V.M.

Regional Clinical Hospital No. 2;
Kuban State Medical University

Gabriel S.A.

Regional Clinical Hospital No. 2;
Kuban State Medical University

Zasyadko O.V.

Kuban State Medical University

Minimally invasive surgical treatment of acute necrotic collections without a progressive exudative component in patients with purulent-necrotic parapancreatitis

Authors:

Remizov S.I., Andreev A.V., Durleshter V.M., Gabriel S.A., Zasyadko O.V.

More about the authors

Journal: Endoscopic Surgery. 2024;30(2): 12‑18

DOI: 10.17116/endoskop20243002112

Read: 1184 times

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Table of contents

MINIMALLY INVASIVE SURGICAL TREATMENT OF ACUTE NECROTIC COLLECTIONS WITHOUT A PROGRESSIVE EXUDATIVE COMPONENT IN PATIENTS WITH PURULENT-NECROTIC PARAPANCREATITIS
MINIMALLY INVASIVE SURGICAL TREATMENT OF ACUTE NECROTIC COLLECTIONS WITHOUT A PROGRESSIVE EXUDATIVE COMPONENT IN PATIENTS WITH PURULENT-NECROTIC PARAPANCREATITIS

To cite this article:

Remizov SI, Andreev AV, Durleshter VM, Gabriel SA, Zasyadko OV. Minimally invasive surgical treatment of acute necrotic collections without a progressive exudative component in patients with purulent-necrotic parapancreatitis. Endoscopic Surgery. 2024;30(2):12‑18. (In Russ.)
https://doi.org/10.17116/endoskop20243002112

Подписка 2026 Эндоскопическая хирургия (Endoscopic Surgery)
МСФ на ЯМ
Использование инфографики авторами научных работ
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Abstract:

BACKGROUND

The main problem in the use of minimally invasive methods of treatment in patients with acute necrotic accumulations with a predominance of the tissue component during its infection is the difficulty in visualizing the liquid part of the purulent-necrotic focus according to ultrasound data, which is guided when making an access during the application of puncture-drainage interventions.

OBJECTIVE

Development of an effective method for the sanitation of infected acute necrotic accumulations with a predominance of the tissue component in purulent-necrotic parapancreatitis using minimally invasive intervention technologies.

MATERIAL AND METHODS

From 2014 to 2019, out of 318 treated patients with purulent-necrotic parapancreatitis, 64 (20.1%) were verified acute necrotic accumulations with a predominance of the tissue component. The patients underwent primary drainage with double-lumen drains according to the method developed in the clinic; in some patients, transfistular videoscopic necrosequestrectomy was additionally performed to increase the efficiency of removing necrotic tissue.

RESULTS

A total of 398 minimally invasive interventions were performed in patients with acute necrotic accumulations with a predominance of the tissue component. The puncture-drainage technique was the final method of treatment in 57.8% of cases. 18 (28.1%) patients additionally underwent removal of necrotic tissue using transfistula videoscopic necrosequestrectomy. Open methods (laparotomy) were required in 9 (14.1%) patients. Mortality was 15.6%.

CONCLUSION

Drainage of the infected retroperitoneal space according to the developed technique in the surgical treatment of pancreatic necrosis, supplemented in some cases with transfistula necrosequestrectomy, made it possible to reduce the number of open interventions to 14.1% of cases and mortality to 15.6%.

Keywords:

pancreas
infected pancreatic necrosis
minimally invasive interventions
transfistular necrosequestrectomy

Authors:

Remizov S.I.

Regional Clinical Hospital No. 2;
Kuban State Medical University

Andreev A.V.

Regional Clinical Hospital No. 2;
Kuban State Medical University

Durleshter V.M.

Regional Clinical Hospital No. 2;
Kuban State Medical University

Gabriel S.A.

Regional Clinical Hospital No. 2;
Kuban State Medical University

Zasyadko O.V.

Kuban State Medical University

Received:

09.03.2023

Accepted:

24.03.2023

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References:

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