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Volume 09
Journal of Gastrointestinal & Digestive System
ISSN: 2161-069X
Gastro Congress 2019
July 08-09, 2019
conference
series
.com
July 08-09, 2019 | Zurich, Switzerland
14
th
Euro-Global Gastroenterology Conference
Page 23
Nazar Omelchuk, J Gastrointest Dig Syst 2019, Volume 09
Minimally-invasive methods of acute pancreatic post necrotic pseudocyst treatment
Statement of the Problem:
Acute necrotic pancreatitis (ANP) remains complicated problem of urgent surgery because
of high frequency of systemic, purulent and septic complications, mortality rate, which is in patients with infected
pancreonecrosis 14.7-26.4%.
Purpose:
The purpose of this study is to evaluate efficiency and establish indications for minimally invasive methods of
treatment of post-necrotic pseudocyst of pancreas.
Methodology &Theoretical Orientation:
For diagnostics ultrasonography was used, diagnostic laparoscopy, helical CT
with contrast strengthening. Endoscopic interventions were applied by duodenoscopes “Olympus” under control of X-ray
machine “Siemens BV 300”. Cystodigestive fistulas were created by prickly papilotoms. For providing of long passability
of cystodigestive fistula were used two endoprostheses like “pig tail” sized 10 Ft with length 5-6 cm. For transpapillary
drainage were used pancreatic endoprostheses like “pig tail”, sized 5-7 Ft with length 5 cm.
Findings:
In 82 (68.2%) patients were applied minimally invasive methods of treatment; Percutaneous external drainage
in 38 (46.3 %) patients, endoscopic transmural drainage of post-necrotic pseudocyst in 22 (26.85%) patients. Combined
endoscopic interventions were applied in 22 (26.85%) patients. In particular, endoscopic transmural drainage with
temporary stenting of pancreatic duct in 11 (50%) patients, endobiliary stenting with temporary stenting of pancreatic
duct in 5 (22.7%) patients, temporary stenting of pancreatic duct in 4 (18.2%) patients, endoscopic transmural drainage
with percutaneous external drainage in 2 (9.1%) patient.
Conclusion & Significance:
Usage of combined minimally invasive methods of treatment of acute necrotic pancreatitis
complicated by post-necrotic pseudocyst help to improve results of treatment, reduction of complications amount,
contraction of stationary treatment terms and improving of life quality.
Recent Publications
1.
Madacsy L, Kurucsai G and Joo I (2009) Rescue ERCP and insertion of small-calibre pancreatic stent to prevent
the evolution of severe post-ERCP pancreatitis: a case-controlled series. Surg. Endosc. 23(8):1887-93.
Nazar Omelchuk
Ivano-Frankivsk National Medical University, Ukraine