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Direct Endoscopic Necrosectomy of a Recurrent Walled-Off Pancreatic Necrosis at High Risk for Severe Bleeding: A Hybrid Technique Using a Dedicated Device.
Binda, Cecilia; Coluccio, Chiara; Vizzuso, Antonio; Sartini, Alessandro; Sbrancia, Monica; Cucchetti, Alessandro; Giampalma, Emanuela; Fabbri, Stefano; Ercolani, Giorgio; Fabbri, Carlo.
Afiliação
  • Binda C; Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, AUSL Romagna, 47121 Forlì, Italy.
  • Coluccio C; Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, AUSL Romagna, 47121 Forlì, Italy.
  • Vizzuso A; Radiology Unit, Morgagni-Pierantoni Hospital, AUSL Romagna, 47121 Forlì, Italy.
  • Sartini A; Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, AUSL Romagna, 47121 Forlì, Italy.
  • Sbrancia M; Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, AUSL Romagna, 47121 Forlì, Italy.
  • Cucchetti A; Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi Hospital, University of Bologna, 40138 Bologna, Italy.
  • Giampalma E; General and Oncologic Surgery, Morgagni-Pierantoni Hospital, AUSL Romagna, 47121 Forlì, Italy.
  • Fabbri S; Radiology Unit, Morgagni-Pierantoni Hospital, AUSL Romagna, 47121 Forlì, Italy.
  • Ercolani G; Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, AUSL Romagna, 47121 Forlì, Italy.
  • Fabbri C; Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi Hospital, University of Bologna, 40138 Bologna, Italy.
Diagnostics (Basel) ; 13(14)2023 Jul 10.
Article em En | MEDLINE | ID: mdl-37510064
Direct endoscopic necrosectomy (DEN) is a challenging procedure for the debridement of walled-off pancreatic necrosis (WOPN), which may be complicated by several adverse events, primarily bleeding which may require radiological embolization or even surgery. The lack of dedicated devices for this purpose largely affects the possibility of safely performing DEN which increases the risk of complications. We present the case of a 63 years-old man who underwent an endoscopic ultrasound (EUS)-guided drainage of a WOPN, and who was readmitted one month after stent removal with clinical, endoscopic, and radiological signs of infected necrosis involving the splenic artery. A second EUS-guided drainage was performed, with clear visualization of the arterial vessel in the midst of a large amount of solid necrosis. Due to the high risk of major bleeding during DEN, a hybrid procedure in the angiographic room was performed, in order to identify and avoid, under fluoroscopic control, the splenic artery during the entire procedure guide, which was successfully performed using the EndoRotor system. We hereby review the current literature regarding DEN using the EndoRotor system. The case reported, with a literature overview, may help the management of these patients affected by benign but life-threatening conditions which involve a multidisciplinary setting.
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Texto completo: 1 Base de dados: MEDLINE Tipo de estudo: Etiology_studies / Prognostic_studies / Risk_factors_studies Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Tipo de estudo: Etiology_studies / Prognostic_studies / Risk_factors_studies Idioma: En Ano de publicação: 2023 Tipo de documento: Article