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Laparoscopic infracolic necrosectomy for infected pancreatic necrosis

Laparoscopic infracolic necrosectomy for infected pancreatic necrosis Infected pancreatic necrosis carries a high morbidity and mortality from sepsis and multisystem organ failure. Following confirmation of the infection by CT-guided fine needle aspiration, treatment consists of broad spectrum antibiotics (imipenim-cilastin) followed by emergency open (laparotomy) digital necrosectomy and insertion of drains for postoperative lavage with hyperosmolar dialysate as advocated by Beger et al. This video shows an alternative laparoscopic technique to open necrosectomy and has been used in Dundee since 1994. After elevation of the transverse colon, the lesser sac is opened through the root of the transverse colon between the middle and left colic vessels. The necrosectomy is accomplished from inside the lesser sac under vision with a combination of pulsed irrigation and graspers. On completion of the necrosectomy, two large drains are inserted into the lesser sac for postoperative irrigation. The experience with this technique has been favorable with a patient survival of 85%. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Surgical Endoscopy Springer Journals

Laparoscopic infracolic necrosectomy for infected pancreatic necrosis

Adamson, G. D.; Cuschieri, A.
Surgical Endoscopy , Volume 17 (10) – Sep 29, 2003
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Laparoscopic infracolic necrosectomy for infected pancreatic necrosis

Abstract

Infected pancreatic necrosis carries a high morbidity and mortality from sepsis and multisystem organ failure. Following confirmation of the infection by CT-guided fine needle aspiration, treatment consists of broad spectrum antibiotics (imipenim-cilastin) followed by emergency open (laparotomy) digital necrosectomy and insertion of drains for postoperative lavage with hyperosmolar dialysate as advocated by Beger et al. This video shows an alternative laparoscopic technique to open...
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Publisher
Springer Journals
Copyright
Copyright © 2003 by Springer-Verlag
Subject
Philosophy
ISSN
0930-2794
eISSN
1432-2218
DOI
10.1007/s00464-003-0041-6
pmid
14973724
Publisher site
See Article on Publisher Site

Abstract

Infected pancreatic necrosis carries a high morbidity and mortality from sepsis and multisystem organ failure. Following confirmation of the infection by CT-guided fine needle aspiration, treatment consists of broad spectrum antibiotics (imipenim-cilastin) followed by emergency open (laparotomy) digital necrosectomy and insertion of drains for postoperative lavage with hyperosmolar dialysate as advocated by Beger et al. This video shows an alternative laparoscopic technique to open necrosectomy and has been used in Dundee since 1994. After elevation of the transverse colon, the lesser sac is opened through the root of the transverse colon between the middle and left colic vessels. The necrosectomy is accomplished from inside the lesser sac under vision with a combination of pulsed irrigation and graspers. On completion of the necrosectomy, two large drains are inserted into the lesser sac for postoperative irrigation. The experience with this technique has been favorable with a patient survival of 85%.

Journal

Surgical Endoscopy – Springer Journals

Published: Sep 29, 2003

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