Outcomes after implementing a tailored endoscopic step-up approach to walled-off necrosis in acute pancreatitis  

Oleh:

Bang, J. Y. ; Holt, B. A. ; Hawes, R. H. ; Hasan, M. K. ; Arnoletti, J. P.

Jenis: Article from Article - diterbitkan di jurnal ilmiah internasional
Dalam koleksi: BJS: British Journal of Surgery vol. 101 no. 13 (Dec. 2014), page 1729-1738.

Ketersediaan

Perpustakaan FK Nomor Panggil: B15.K Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Methods This was an observational before–after study of consecutive patients managed over two time intervals. In the initial period (2004–2009) symptomatic patients with walled-off necrosis underwent conventional single transmural drainage with placement of two stents and a nasocystic catheter, followed by direct endoscopic necrosectomy, if required. In the later period (2010–2013) an algorithmic approach was adopted based on size and extent of the walled-off necrosis and stepwise response to intervention. The main outcome was treatment success, defined as a reduction in walled-off necrosis size to 2?cm or less on CT after 8?weeks. Results Forty-seven patients were treated in the first interval and 53 in the second. There was no difference in patient demographics, clinical or walled-off necrosis characteristics and laboratory parameters between the groups, apart from a higher proportion of women and Caucasians in the later period. The treatment success rate was higher for the algorithmic approach compared with conventional treatment (91 versus 60 per cent respectively; P?

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