Akute Pankreatitis: Minimalinvasiver und interventioneller Ansatz bei infizierten Pankreasnekrosen

Zusammenfassung

Die Nekrosektomie bei infizierten Nekrosen nach akuter Pankreatitis wurde in den vergangenen Jahren durch die Einführung einer Vielzahl von interventionellen und minimalinvasiven Techniken revolutioniert. In der vorliegenden Arbeit liefern wir eine Übersicht und Wertung des Armamentariums minimalinvasiver chirurgischer und interventioneller Techniken. Laparoskopisch-endoskopische Kombinationsverfahren und minimalinvasive Verfahren liefern viel versprechende Ergebnisse, müssen sich aber an den Ergebnissen der etablierten offenen chirurgischen Verfahren messen und erfordern eine Evaluation in größeren Serien.

Abstract

Necrosectomy of infected necroses after acute pancreatitis was revolutionized in recent years by introduction of a number of interventional and minimal invasive techniques. In the present article we review and evaluate the armamentarium of minimal invasive surgical and interventional techniques. Laparoscopic-endoscopic rendezvous manoeuvres and minimal invasive operations deliver promising results, have however to be compared to results of long standing open surgery and warrant an evaluation in larger series.

akute Pankreatitis - Nekrosen - minimalinvasive Chirurgie - Intervention - Übersichtsarbeit

acute pancreatitis - necrosis - minimal invasive surgery - intervention - review

Literatur

• 1 Baron T, Thaggard W, Morgan D. et al . Endoscopic therapy for organized pancreatic necrosis.  Gastroenterology. 1996;  111 755-764
• 2 Baron T, Morgan D. Endoscopic transgastric irrigation tube placement via PEG fordebridement of organized pancreatic necrosis.  Gastrointest Endosc. 1999;  50 574-577
• 3 Beger H G, Bittner R, Block S. et al . Bacterial contamination of pancreatic necrosis. A prospective clinical study.  Gastroenterology. 1986;  91 433-438
• 4 Beger H G, Buchler M, Bittner R. et al . Necrosectomy and postoperative locallavage in necrotizing pancreatitis.  Br J Surg. 1988;  75 207-212
• 5 Bosscha K, Hulstaert P F, Hennipman A. et al . Fulminant acute pancreatitis and infected necrosis: results of open management of the abdomen and “plannes” reoperations.  J Am Coll Surg. 1998;  187 255-262
• 6 Bradley 3rd  E L. A fifteen year experience with open drainage for infected pancreatic necrosis.  Surg Gynecol Obstet. 1993;  177 215-222
• 7 Buchler M W, Gloor B, Muller C A. et al . Acute necrotizing pancreatitis: treatment strategy according to the status of infection.  Ann Surg. 2000;  232 619-626
• 8 Carter C, McKay C J, Imrie C. Percutaneous necrosectomy and sinus tract endoscopy in the management of infected pacreatic necrosis: an initial experience.  Ann Surg. 2000;  232 175-180
• 9 Castellanos G, Pinero A, Serrano A. et al . Infected pancreatic necrosis: translumbar approach and management with retroperitoneoscopy.  Arch Surg. 2002;  137 1060-1062
• 10 Connor S, Ghaneh P, Raraty M. et al . Minimally invasive retroperitoneal pancreatic necrosectomy.  Dig Surg. 2003;  20 270-277
• 11 Echenique A M, Sleeman D, Yrizarry J. et al . Percutaneous catheter-directed debridement of infected pancreatic necrosis: results in 20 patients.  J Vasc Interv Radiol. 1998;  9 565-571
• 12 Farkas G, Marton J, Mandi Y. et al . Surgical strategy and management of inffected pancreatic necrosis.  Br J Surg. 1996;  83 930-933
• 13 Fernandez-del Castillo C, Rattner D W, Makary M A. et al . Debridement and closed packing for the treatment of necrotizing pancreatitis.  Ann Surg. 1998;  228 676-684
• 14 Freeny P C, Hauptmann E, Althaus S J. et al . Percutaneous CT-guided catheter drainage of infected acute necrotizing pancreatitis: techniques and results.  AJR Am J Roentgenol. 1998;  170 969-975
• 15 Gambiez L, Denimal F, Porte H. et al . Retroperitoneal approach and endoscopic management of peripancreatic necrosis collections.  Arch Surg. 1998;  133 66-72
• 16 Gmeinwieser J, Feuerbach S, Zirngibl H. et al . Percutaneous treatment of infected necrotizing pancreatitis.  Eur IHPBA. 1997;  23 575-578
• 17 Gouzi J L, Bloom E, Julio C. et al . Percutaneous drainage of infected pancreatic necrosis: an alternative to surgery.  Chirurgie. 1999;  124 31-37
• 18 Horvath K, Kao L, Ali A. et al . Laparoscopic assisted percutaneous drainage of infected pancreatic necrosis.  Surg Endosc. 2001;  15 677-682
• 19 Johnson C D, Kingsnorth A N, Imrie C W. et al . Double blind, randomised, placebo controlled study of a platelet activating factor antagonist, lexipafant, in the treatment and prevention of organ failure in predicted severe acute pancreatitis.  Gut. 2001;  48 62-69
• 20 Mier J, Leon E L, Castillo A. et al . Early versus late necrosectomy in severe nocrotizing pancreatitis.  Am J Surg. 1997;  173 71-75
• 21 Nieuwenhuijs V B, Besselink M G, van Minnen L P. et al . Surgical management of acute necrotizing pancreatitis: a 13-year experience and a systematic review.  Scand J Gastroenterol Suppl. 2003;  239 111-116
• 22 Risse O, Auguste T, Delannoy P. et al . Percutaneous video-assisted necrosectomy for infected pancreatic necrosis.  Gastroenterol Clin Biol. 2004;  28 868-871
• 23 Sarr M G, Nagorney D M, Mucha Jr  P. et al . Acute necrotizing pancreatitis: management by planned, staged pancreatic necrosectomy/debridement and delayed primary wound closure over drains.  Br J Surg. 1991;  78 576-581
• 24 Seewald S, Groth S, Omar S. et al . Aggressive endoscopic therapy for pancreatic necrosis and pancreatic abscess: a new safe and effective treatment algorithm (videos).  Gastrintest Endosc. 2005;  62 92-100
• 25 Szentkereszty Z, Kerekes L, Hallay J. et al . CT-guided percutaneous drainage in the treatment of acute necrotizing pancreatitis.  Magy Seb. 2001;  54 11-14
• 26 Tsiotos G G, Luque-de Leon E, Soreide J A. et al . Management of necrotizing pancreatitis by repeated operative necrosectomy using a zipper technique.  Am J Surg. 1998;  175 91-98
• 27 Uhl W, Warshaw A, Imrie C. et al . IAP Guidelines for the surgical management of acute pancreatitis.  Pancreatology. 2002;  2 565-573
• 28 British Society of Gastroenterology . United Kingdom guidelines for the management of acute pancreatitis.  Gut. 1998;  42 (Suppl 2) 1-13
• 29 Zhou Z G, Zheng Y C, Shu Y. et al . Laparoscopic management of severe aute pancreatitis.  Pancreas. 2003;  27 e46-e50
• 30 Zhu J, Fan X, Zhang X. Laparoscopic treatment of severe acute pancreatitis.  Surg Endosc. 2001;  15 146-148