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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Transluminal retroperitoneal endoscopic necrosectomy with the use of hydrogen peroxide and without external irrigation: A novel approach for the treatment of walled-off pancreatic necrosis
Surgical Endoscopy, Volume 27, No. 10, Year 2013
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Description
Background: Transluminal retroperitoneal endoscopic necrosectomy (TREN) is an attractive NOTES technique alternative to surgery for treatment of walled-off pancreatic necrosis (WOPN). The main limitations to this technique are the need for repeated sessions, prolonged external irrigation, and EUS availability. In our study, we introduced new modifications, including the use of hydrogen peroxide, and abandoning the use of EUS and external irrigation. Methods: This is a retrospective study of outcome of consecutive patients who underwent TREN for WOPN between April 2011 and August 2012. The technique included (1) non-EUS-guided transluminal drainage, and (2) direct endoscopic debridement using hydrogen peroxide and different accessories. No external irrigation was used. Results: Ten patients were included. Initial clinical and technical success was achieved in all patients. Complete radiological success and long-term clinical efficacy was achieved in nine patients (1 patient had an inaccessible left paracolic gutter collection and died 62 days after endotherapy). Mean number of sessions was 1.4 (range 1-2). Complications included bleeding, which was self-limited in three patients and endoscopically controlled in one. All patients avoided surgery, and no recurrence was reported during median follow-up of 289 (range 133-429) days. Conclusions: TREN is a safe and effective treatment for WOPN and could be performed safely without EUS guidance in selected cases. Hydrogen peroxide played a major role in reduction of number of sessions and timing. External irrigation of WOPN is not necessary, if adequate debridement could be achieved. © 2013 Springer Science+Business Media New York.
Authors & Co-Authors
Abdelhafez, Mohamed
Egypt, Cairo
Cairo University Hospitals
Elnegouly, Mayada Mohamed
Egypt, Cairo
Cairo University Hospitals
Hasab Allah, Maha S.
Egypt, Giza
Cairo University
Elshazli, Mostafa M.
Egypt, Giza
Cairo University
Mikhail, Hany M.S.
Egypt, Giza
Cairo University
Yosry, Ayman
Egypt, Cairo
Cairo University Hospitals
Statistics
Citations: 59
Authors: 6
Affiliations: 2
Identifiers
Doi:
10.1007/s00464-013-2948-x
ISSN:
09302794
e-ISSN:
14322218
Research Areas
Health System And Policy
Study Design
Cohort Study