medigraphic.com
ISSN 1665-2576 (Print)

2022, Number 1-2

<< Back

Rev Mex Cir Endoscop 2022; 23 (1-2)

Minimally invasive surgery for necrotizing pancreatitis: a case report

Vergara-Miranda H, Flores-González AK, Alvarez-Lozada LA, Galindo-Sotelo GD, Mata-de AA, Zorrilla-Núñez LF

Language: Spanish
References: 11
Page: 46-49
PDF size: 180.51 Kb.


ABSTRACT

Introduction: acute pancreatitis is one of the most common gastrointestinal diseases found in clinical practice. Of these cases, 10-20% may be associated with necrosis of the pancreatic gland. There are different surgical approaches where it is important to carry out a correct approach, ensuring that it is as minimally invasive as in the case presented. Case report: we present the case of a 59-year-old man with abdominal pain and a contrast-enhanced tomography that showed evidence of Balthazar E necrotizing pancreatitis and duodenal fistula. The patient underwent transgastric pancreatic necrosectomy with laparoscopy with drainage and debriedment of purulent material and necrotic tissue. The postoperative period was uneventful and the patient was discharged on the twelfth postoperative day. Conclusion: transgastric necrosectomy was an approrpriate procedure for this patient and is an excellent first-stage surgical option for symptomatic pancreatic necrosis. Precise surgical techniques and long-term outpatient follow-up are mandatory for optimal patient outcomes. Determining the best approach for our patients reduces morbidity and improves postoperative recovery.


REFERENCES

  1. Baron TH, DiMaio CJ, Wang AY, Morgan KA. American gastroenterological association clinical practice update: management of pancreatic necrosis. Gastroenterology. 2020; 158: 67-75.e1.

  2. Stamatakos M, Stefanaki C, Kontzoglou K, Stergiopoulos S, Giannopoulos G et al. Walled-off pancreatic necrosis. World J Gastroenterol. 2010; 16: 1707-1712.

  3. Van Santvoort HC, Besselink MG, Bakker OJ, Hofker HS, Boermeester MA, Dejong CH et al. A step-up approach or open necrosectomy for necrotizing pancreatitis. N Engl J Med. 2010; 362: 1491-1502.

  4. Driedger M, Zyromski NJ, Visser BC, Jester A, Sutherland FR, Nakeeb A. Surgical transgastric necrosectomy for necrotizing pancreatitis: a single-stage procedure for walled-off pancreatic necrosis. Ann Surg. 2020; 271: 163-168.

  5. Doherty GM. Current diagnosis & treatment surgery. 15th ed. McGraw Hill; 2020.

  6. Burr NE, Lord R, Hull MA, Subramanian V. Decreasing risk of first and subsequent surgeries in patients with Crohn's disease in England from 1994 through 2013. Clin Gastroenterol Hepatol. 2019; 17: 2042-2049.e4.

  7. Bakker OJ, Van Santvoort HC, Van Brunschot S, Geskus RB, Besselink MG, Bollen TL et al. Endoscopic transgastric vs surgical necrosectomy for infected necrotizing pancreatitis: a randomized trial. JAMA. 2010; 307: 1053-1061.

  8. Angeles-Mar HJ, Elizondo-Omaña RE, Guzmán-López S, Quiroga-Garza A. Early laparoscopic cholecystectomy in acute gallbladder perforation –Single– centre experience. J Minim Access Surg. 2022; 18: 324-325.

  9. Quiroga-Garza A, Alvarez-Villalobos NA, Angeles-Mar HJ, Garcia-Campa M, Muñoz-Leija MA et al. Localized gallbladder perforation: a systematic review of treatment and prognosis. HPB (Oxford). 2021; 23: 1639-1646.

  10. Agha RA, Franchi T, Sohrabi C, Mathew G, SCARE Group. The SCARE 2020 Guideline: Updating Consensus Surgical CAse REport (SCARE) guidelines. Int J Surg. 2020; 84: 226-230.

  11. Riley DS, Barber MS, Kienle GS, Aronson JK, Von Schoen-Angerer T, Tugwell P et al. CARE guidelines for case reports: explanation and elaboration document. J Clin Epidemiol. 2017; 89: 218-235.




2020     |     www.medigraphic.com