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Review
. 2015:2015:693040.
doi: 10.1155/2015/693040. Epub 2015 Oct 26.

Minimally Invasive Necrosectomy Techniques in Severe Acute Pancreatitis: Role of Percutaneous Necrosectomy and Video-Assisted Retroperitoneal Debridement

Jennifer A Logue  1 , C Ross Carter  1
Affiliations
Review

Minimally Invasive Necrosectomy Techniques in Severe Acute Pancreatitis: Role of Percutaneous Necrosectomy and Video-Assisted Retroperitoneal Debridement

Jennifer A Logue et al. Gastroenterol Res Pract. 2015.

Abstract

Consensus advocating a principle of early organ support, nutritional optimisation, followed ideally by delayed minimally invasive intervention within a "step-up" framework where possible has radically changed the surgical approach to complications of acute pancreatitis in the last 20 years. The 2012 revision of the Atlanta Classification incorporates these changes, and provides a background which underpins the complexities of individual patient management decisions. This paper discusses the place for delayed minimally invasive surgical intervention (percutaneous necrosectomy, video-assisted retroperitoneal debridement (VARD)), and the rationale for opting to adopt a percutaneous approach over endoscopic or laparoscopic approaches in different clinical situations.

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Figures

Figure 1
Figure 1
Acute walled-off pancreatic necrotic collection (W. O. P. N) at 6 weeks.
Figure 2
Figure 2
Retroperitoneal drain following enhanced “step-up” percutaneous necrosectomy in same patient as in Figure 1.
See this image and copyright information in PMC

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