Percutaneous transgastric irrigation drainage in combination with endoscopic necrosectomy in necrotizing pancreatitis (with videos)

Gastrointest Endosc. 2006 Sep;64(3):420-4. doi: 10.1016/j.gie.2006.02.052.

Abstract

Background: Endoscopic drainage of pancreatic acute and chronic pseudocysts and pancreatic necrosectomy have been shown to be beneficial for critically ill patients, with complete endoscopic resolution rates of around 80%.

Objective: Our purpose was to describe an improved endoscopic technique used to treat pancreatic necrosis.

Design: Case report.

Setting: University hospital.

Patients and interventions: Two patients with large retroperitoneal necroses were treated with percutaneous transgastric retroperitoneal flushing tubes and a percutaneous transgastric jejunal feeding tube by standard percutaneous endoscopic gastrostomy access in addition to endoscopic necrosectomy.

Results: Intensive percutaneous transgastric flushing in combination with percutaneous normocaloric enteral nutrition and repeated endoscopic necrosectomy led to excellent outcomes in both patients.

Limitations: Small number of patients.

Conclusions: The "double percutaneous endoscopic gastrostomy" approach for simultaneous transgastric drainage and normocaloric enteral nutrition in severe cases of pancreatic necroses is safe and effective. It could be a promising improvement to endoscopic transgastric treatment options in necrotizing pancreatitis.

Publication types

  • Case Reports

MeSH terms

  • Drainage / methods*
  • Endoscopy, Gastrointestinal / methods*
  • Humans
  • Male
  • Middle Aged
  • Pancreas / pathology*
  • Pancreatitis, Acute Necrotizing / therapy*
  • Treatment Outcome
  • Video Recording