Step-up approach combined with negative pressure wound therapy for the treatment of severe necrotizing pancreatitis: a case report.
Clin J Gastroenterol
; 13(6): 1331-1337, 2020 Dec.
Article
em En
| MEDLINE
| ID: mdl-32712840
ABSTRACT
A step-up approach and continuous drainage using NPWT was an effective strategy for the treatment of severe necrotizing pancreatitis. A 62-year-old woman developed severe necrotizing pancreatitis after endoscopic retrograde cholangiopancreatography, extending from the left anterior pararenal space to the interior renal pole. Endoscopic transluminal drainage and percutaneous catheter drainage were unsuccessful in controlling the disease. We proceeded with video-assisted retroperitoneal necrosectomy, at the pancreas and splenic hilum, and drainage, with two additional surgical drains located at the left inferior renal pole and, subcutaneously, at the incision wound. NPWT enhanced fluid drainage and facilitated surgical wound closure, which was infected and opened. Four subsequent endoscopic necrosectomy procedures were required, at the site of the draining fistula, to achieve complete resolution of fluid collection and wound closure.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pancreatite Necrosante Aguda
/
Tratamento de Ferimentos com Pressão Negativa
Limite:
Female
/
Humans
/
Middle aged
Idioma:
En
Revista:
Clin J Gastroenterol
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Japão