Direct transfistulous ultrasound in minimally invasive surgical treatment of infected pancreatic necrosis

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

doi:https://doi.org/10.17116/hirurgia202404138

Remizov S.I.

Regional Clinical Hospital No. 2;
Kuban State Medical University

ORCID: 0000-0001-9410-9493

Andreev A.V.

Regional Clinical Hospital No. 2;
Kuban State Medical University

ORCID: 0000-0003-0945-9400

Durleshter V.M.

Regional Clinical Hospital No. 2;
Kuban State Medical University

ORCID: 0000-0002-7420-0553

Gabriel S.A.

Regional Clinical Hospital No. 2;
Kuban State Medical University

ORCID: 0000-0002-0755-903X

Zasyadko O.V.

Kuban State Medical University

ORCID: 0000-0003-0625-0791

Direct transfistulous ultrasound in minimally invasive surgical treatment of infected pancreatic necrosis

Authors:

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

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2024;(4): 38‑43

DOI: 10.17116/hirurgia202404138

Read: 992 times

Download PDF (RU)

Contact the author

Table of contents

To cite this article:

Remizov SI, Andreev AV, Durleshter VM, Gabriel SA, Zasyadko OV. Direct transfistulous ultrasound in minimally invasive surgical treatment of infected pancreatic necrosis. Pirogov Russian Journal of Surgery. 2024;(4):38‑43. (In Russ.)
https://doi.org/10.17116/hirurgia202404138

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)

Использование инфографики авторами научных работ

Close metadata

OBJECTIVE

To develop a method for direct transfistulous ultrasound in minimally invasive treatment of infected pancreatic necrosis.

MATERIAL AND METHODS

There were 148 patients with infected pancreatic necrosis between 2015 and 2019 at the Krasnodar City Clinical Hospital No. 2. Drainage with 28—32 Fr tubes was carried out at the first stage, endoscopic transfistulous sequestrectomy — at the second stage (19 (12.8%) patients). In 84 (56.8%) patients, we applied original diagnostic method (transfistulous ultrasonic assessment of inflammatory focus).

RESULTS

There were 3 accesses to omental bursa in 93 (62.8%) patients and 2 in 43 (29.1%) patients. We also performed 2 access to retroperitoneal space in 63 (42.6%) patients and 1 access in 38 (25.8%) cases. Transfistulous ultrasound was used once in 19 (22.6%) patients, twice in 28 (33.3%) and 3 times in 37 (44.1%) patients. Examination was not performed in 18 (12.2%) patients due to the following reasons: migration of drainage catheters — 5, non-rectilinear fistulous tract — 13. No complications were observed.

CONCLUSION

Transfistulous ultrasound makes it possible to diagnose pathological changes in the pancreas and parapancreatic tissue at various stages of surgical treatment.

Keywords:

pancreas

infected pancreatic necrosis

minimally invasive interventions

transfistulous ultrasound

Authors:

Remizov S.I.

Regional Clinical Hospital No. 2;
Kuban State Medical University

ORCID: 0000-0001-9410-9493

Andreev A.V.

Regional Clinical Hospital No. 2;
Kuban State Medical University

ORCID: 0000-0003-0945-9400

Durleshter V.M.

Regional Clinical Hospital No. 2;
Kuban State Medical University

ORCID: 0000-0002-7420-0553

Gabriel S.A.

Regional Clinical Hospital No. 2;
Kuban State Medical University

ORCID: 0000-0002-0755-903X

Zasyadko O.V.

Kuban State Medical University

ORCID: 0000-0003-0625-0791

Received:

05.09.2023

Accepted:

28.09.2023

Close metadata

References:

Coffin A, Boulay-Coletta I, Sebbag-Sfez D, Zins M. Radioanatomy of the retroperitoneal space. Diagnostic and Interventional Imaging. 2015;96(2):171-186. https://doi.org/10.1016/j.diii.2014.06.015
Sharma M, Madambath JG, Somani P, Pathak A, Rameshbabu CS, Bansal R, Ramasamy K, Patil A. Endoscopic ultrasound of peritoneal spaces. Endoscopic ultrasound. 2017;6(2):90-102. https://doi.org/10.4103/2303-9027.204816
Sharma M, Patil A, Kumar A, Pathak A, Somani P, Sreesh SS, Rameshbabu CS. Imaging of infracolic and pelvic compartment by linear EUS. Endoscopic ultrasound. 2019;8(3):161-171. https://doi.org/10.4103/eus.eus_25_19
Ashouri M, Tadbir Vajargah K, Mohammadzadeh N, Sahraian S. A huge preperitoneal collection following acute necrotizing pancreatitis: A case report and the management approach. Annals of Medicine and Surgery. 2022;78:103843. https://doi.org/10.1016/j.amsu.2022.103843
Triester SL, Kowdley KV. Prognostic factors in acute pancreatitis. Journal of Clinical Gastroenterology. 2002;34(2):167-176. https://doi.org/10.1097/00004836-200202000-00014
Cai D, Parajuly SS, Wang H, Wang X, Ling W, Song B, Li Y, Luo Y. Accuracy of contrast-enhanced ultrasound compared with conventional ultrasound in acute pancreatitis: Diagnosis and complication monitoring. Experimental and Therapeutic Medicine. 2016;12(5):3189-3194. https://doi.org/10.3892/etm.2016.3760
Wessling J, Peitz U, Hoffmann M, Schreyer AG, Grenacher L. Akute Pankreatitis: Typische Befunde in Computer- und Magnetresonanztomographie [Acute pancreatitis: Typical findings in computed tomography and magnetic resonance imaging]. Radiologe. 2021;61(6):532-540. https://doi.org/10.1007/s00117-021-00854-y
Brizi MG, Perillo F, Cannone F, Tuzza L, Manfredi R. The role of imaging in acute pancreatitis. Radiologia Medica. 2021;126(8):1017-1029. https://doi.org/10.1007/s11547-021-01359-3
Shyu JY, Sainani NI, Sahni VA, Chick JF, Chauhan NR, Conwell DL, Clancy TE, Banks PA, Silverman SG. Necrotizing pancreatitis: diagnosis, imaging, and intervention. Radiographics. 2014;34(5):1218-1239. https://doi.org/10.1148/rg.345130012
Sureka B, Rai B, Varshney VK, Nag VL, Garg MK, Garg P, Yadav T, Khera PS. Diffusion-Weighted Magnetic Resonance Imaging Is an Ideal Imaging Method to Detect Infection in Pancreatic Collections: A Brief Primer for the Gastroenterologist. Cureus. 2022;14(1):21530. https://doi.org/10.7759/cureus.21530
Freeny PC, Hauptmann E, Althaus SJ, Traverso LW, Sinanan M. Percutaneous CT-guided catheter drainage of infected acute necrotizing pancreatitis: techniques and results. American Journal of Roentgenology. 1998;170(4):969-975. https://doi.org/10.2214/ajr.170.4.9530046
Hollemans RA, Bollen TL, van Brunschot S, Bakker OJ, Ahmed Ali U, van Goor H, Boermeester MA, Gooszen HG, Besselink MG, van Santvoort HC. Dutch Pancreatitis Study Group. Predicting Success of Catheter Drainage in Infected Necrotizing Pancreatitis. Annals of Surgery. 2016;263(4):787-792. https://doi.org/10.1097/SLA.0000000000001203
Husu HL, Kuronen JA, Leppäniemi AK, Mentula PJ. Open necrosectomy in acute pancreatitis-obsolete or still useful? World Journal of Emergency Surgery. 2020;15(1):21. https://doi.org/10.1186/s13017-020-00300-9
Andreyev AV, Durleshter VM, Remizov SI, Gabriel’ SA, Kuznetsov YuS. Sposob chresfistul’noy videoskopicheskoy nekrsekvestrektomii pri gnoyno-nekroticheskom parapankreatite. Patent RF na izobreteniye №2741465/26.01.2021, Byul. №3. Ssylka aktivna na 17.08.23. (In Russ.).
Andreyev AV, Remizov SI, Durleshter VM, Levchenko GA, Gabriel’ SA. Sposob skanirovaniya podzheludochnoy zhelezy pri pankreonekroze. Patent RF na izobreteniye №2786978/27.12.2022. Ssylka aktivna na 17.08.23. (In Russ.).
Starkov YuG, Strekalovsky VP, Vishnevsky VA. Intraoperative ultrasound examination during laparoscopic interventions. Annals of surgical hepatology. 1997;2:94-102. (In Russ.).