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DOI: 10.1055/s-0038-1654619
Outcome of extra-anatomic endoscopic interventions in severe pancreatitis
Publication History
Publication Date:
09 May 2018 (online)
Background:
Pancreatic pseudocysts and necroses are complications of severe pancreatitis. In recent years minimal-invasive endoscopic techniques have become a reliable alternative to surgical procedures and their risk of morbidity. However data on extra-anatomic endoscopic drainage of pseudocysts and necrosectomy are still limited and inconsistant in their study design. This abstract deals with the first data of patients of the 2017 established pancreatitis register of the University of St. Pölten to gain further insights.
Methods:
Data on extra-anatomic interventions performed for complications of pancreatitis at the university clinic between 04/2017 and 02/2018 were gathered. A total of 10 patients were included into the analysis (age mean ± SD: 59 ± 13,7 yr; 6 male, 4 female). Intervention success, need for subsequent interventions, salvage surgery and intervention-related mortality were retrospectively analyzed.
Results:
22 extra-anatomic interventions were performed, 54,5% (12) of these as subsequent interventions. In all cases, indications were pancreatic pseudocysts or walled-off necroses. Each drainage of the target structure was performed successfully. In total, 25 stents were placed in 17 (77,3%) interventions. Most common types of stent deployed were double pigtail stents (18, 72%) followed by Hot AXIOS stents (6, 24%). In one case a surgical intervention was necessary due to non-controlable inflammation. The only death occurred due to acute liver failure post surgery. A limitation was a lack of radiological differentiation between pseudocysts and necroses as well as the inconsequent radiological description of size.
Conclusion:
We observed a high success rate with no procedure-related morbidity or mortality. The data suggests that extra-anatomic interventions pose a viable alternative to invasive surgery for treatment of complications of pancreatitis. Prospective studies are in need to determine their respective significance and to establish patient characteristics to guide treatment choices. A closer cooperation with the department of radiology to improve diagnostics and interventions is planned.