Nephroscopic pancreatic necrosectomy through sinus tracts of drains using a dual-scope necrosectomy approach without the need for anesthesia: a report on 17 patients / 中华肝胆外科杂志

ABSTRACT

Objective:To analyse the use of nephroscopic peripancreatic necrotic tissue removal through drainage tube sinus tracts without the use of anesthesia.Methods:The data of 17 patients with severe acute pancreatitis (SAP) were treated from August 2016 to December 2019 at the Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine were studied. There were 5 males and 12 females, age ranged from 24 to 80 years (mean 49.3 years). These 17 patients underwent nephroscopic pancreatic necrosis tissue removal through drainage tube sinus tracts of drains using a dual-scope necrosectomy approach without the use of any anesthesia. The surgical related and follow-up data were analysed.Results:Of 17 patients who underwent pancreatic necrosis removal as the first operation, one underwent a further postoperative nephroscopic resection without anesthesia, while 10 patients underwent three nephroscopic resections without anesthesia, and 6 patients underwent four nephroscopic resections without anesthesia. The operative durations of nephroscopic resection without anesthesia was 26 to 37 min. All patients had smooth surgical procedures and they were fed on the same day after surgery. There were no postoperative complications on follow-up after discharge from hospital for 1 to 40 months.Conclusion:Transcatheter sinusoidal nephroscopic pancreatic necrotic tissue removal without anesthesia was safe. There was no need for fasting. The procedure is minimally invasive and it can be repeated, especially for those patients who cannot tolerate any form of anesthesia. This is the least invasive procedure for treatment of SAP.