Rendezvous transgastric and percutaneous sinus tract endoscopy (STE) for debridement of necrotic collections with deep retroperitoneal extension: a case series (with video)
Background and study aims Infected necrotic collections extending deep into the retroperitoneum may not be amenable solely to endoscopic necrosectomy. Rendezvous transgastric and percutaneous sinus tract endoscopic necrosectomy was conceived to maximize debridement and obviate the need for open necr...
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Georg Thieme Verlag KG
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doaj-71376b3e5f4f43d79247de569d6de28b2020-11-25T03:16:23ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-97362020-04-010805E668E67210.1055/a-1134-4786Rendezvous transgastric and percutaneous sinus tract endoscopy (STE) for debridement of necrotic collections with deep retroperitoneal extension: a case series (with video)Guru Trikudanathan0Hiba Hashmi1Ahmed Dirweesh2Stuart Amateau3Nabeel Azeem4Shawn Mallery5Martin L. Freeman6Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, Minnesota, United StatesDivision of Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, Minnesota, United StatesDivision of Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, Minnesota, United StatesDivision of Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, Minnesota, United StatesDivision of Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, Minnesota, United StatesDivision of Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, Minnesota, United StatesDivision of Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, Minnesota, United StatesBackground and study aims Infected necrotic collections extending deep into the retroperitoneum may not be amenable solely to endoscopic necrosectomy. Rendezvous transgastric and percutaneous sinus tract endoscopic necrosectomy was conceived to maximize debridement and obviate the need for open necrosectomy or video-assisted retroperitoneal debridement. Patients and methods Patients who underwent simultaneous rendezvous transgastric and sinus tract endoscopic transluminal necrosectomy at the same session were identified from a prospectively maintained database. Demographic data, clinical outcomes, immediate and late complications were evaluated. Results Among 415 patients with necrotizing pancreatitis, four patients (three males, median age 47 years) underwent this intervention after a median 29.5 days following placement of percutaneous drain. Intra-procedural bleeding following dilation of percutaneous tract required placement of esophageal stent for tamponade. No patients required rescue open necrosectomy or video assisted retroperitoneal debridement. Complete removal of percutaneous drains was accomplished in all patients after a median of 78.5 days. Conclusions Our novel approach is safe and effective and can expand the available armamentarium for management of large necrotic collection with deep retroperitoneal extension.http://www.thieme-connect.de/DOI/DOI?10.1055/a-1134-4786 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Guru Trikudanathan Hiba Hashmi Ahmed Dirweesh Stuart Amateau Nabeel Azeem Shawn Mallery Martin L. Freeman |
spellingShingle |
Guru Trikudanathan Hiba Hashmi Ahmed Dirweesh Stuart Amateau Nabeel Azeem Shawn Mallery Martin L. Freeman Rendezvous transgastric and percutaneous sinus tract endoscopy (STE) for debridement of necrotic collections with deep retroperitoneal extension: a case series (with video) Endoscopy International Open |
author_facet |
Guru Trikudanathan Hiba Hashmi Ahmed Dirweesh Stuart Amateau Nabeel Azeem Shawn Mallery Martin L. Freeman |
author_sort |
Guru Trikudanathan |
title |
Rendezvous transgastric and percutaneous sinus tract endoscopy (STE) for debridement of necrotic collections with deep retroperitoneal extension: a case series (with video) |
title_short |
Rendezvous transgastric and percutaneous sinus tract endoscopy (STE) for debridement of necrotic collections with deep retroperitoneal extension: a case series (with video) |
title_full |
Rendezvous transgastric and percutaneous sinus tract endoscopy (STE) for debridement of necrotic collections with deep retroperitoneal extension: a case series (with video) |
title_fullStr |
Rendezvous transgastric and percutaneous sinus tract endoscopy (STE) for debridement of necrotic collections with deep retroperitoneal extension: a case series (with video) |
title_full_unstemmed |
Rendezvous transgastric and percutaneous sinus tract endoscopy (STE) for debridement of necrotic collections with deep retroperitoneal extension: a case series (with video) |
title_sort |
rendezvous transgastric and percutaneous sinus tract endoscopy (ste) for debridement of necrotic collections with deep retroperitoneal extension: a case series (with video) |
publisher |
Georg Thieme Verlag KG |
series |
Endoscopy International Open |
issn |
2364-3722 2196-9736 |
publishDate |
2020-04-01 |
description |
Background and study aims Infected necrotic collections extending deep into the retroperitoneum may not be amenable solely to endoscopic necrosectomy. Rendezvous transgastric and percutaneous sinus tract endoscopic necrosectomy was conceived to maximize debridement and obviate the need for open necrosectomy or video-assisted retroperitoneal debridement.
Patients and methods Patients who underwent simultaneous rendezvous transgastric and sinus tract endoscopic transluminal necrosectomy at the same session were identified from a prospectively maintained database. Demographic data, clinical outcomes, immediate and late complications were evaluated.
Results Among 415 patients with necrotizing pancreatitis, four patients (three males, median age 47 years) underwent this intervention after a median 29.5 days following placement of percutaneous drain. Intra-procedural bleeding following dilation of percutaneous tract required placement of esophageal stent for tamponade. No patients required rescue open necrosectomy or video assisted retroperitoneal debridement. Complete removal of percutaneous drains was accomplished in all patients after a median of 78.5 days.
Conclusions Our novel approach is safe and effective and can expand the available armamentarium for management of large necrotic collection with deep retroperitoneal extension. |
url |
http://www.thieme-connect.de/DOI/DOI?10.1055/a-1134-4786 |
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