Outcome of Laparoscopic Necrosectomy in 15 Patients with Infected Pancreatic Necrosis

Prabhdeep Nain, Prof, Satpal Virk. DAYANAND MEDICAL COLLEGE & HOSPITAL, LUDHIANA

Introduction: Infected pancreatic necrosis is a life-threatening complication of acute pancreatitis that has been traditionally managed with open surgical debridement.

Treatment of pancreatic necrosis has evolved considerably over the past decade with respect to both the timing of intervention & the development of alternatives to traditional open necrosectomy.

AIMS & OBJECTIVES: To study the outcome of laparoscopic pancreatic necrosectomy performed in patients with infective pancreatic necrosis in terms of; Morbidity (GI fistula, haemorrhage, recurrence/ intervention).
Length of stay (ICU, hospital) Mortality  .

RESULTS: We studied the outcome of 15 cases of infected pancreatic necrosis managed by laparoscopic pancreatic necrosectomy as regards morbidity, length of stay & mortality.

In present study transperitoneal approach access to lesser sac, right and left paracolic gutter, perinepheric space, retroduodenal space & root of mesentery was accomplished for drainage.

Each patient’s treatment was individualized & preoperative CT scan guided the approach.

Stay of patients was average 8 days, 10 developed pancreatic fistula, all required irrigation which was taught to patients relatives.

2 patients required laparotomy. 2 others required pigtail drainage of residual collections by CT guided radiological drains.

There was one mortality.

CONCLUSIONS: Laparoscopic necrosectomy is a feasible procedure in acute infected pancreatic necrosis. We report similar rate of complications as open necrosectomy but with less morbidity to the patients.

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