Zusammenfassung
Die Nekrosektomie bei infizierten Nekrosen nach akuter Pankreatitis wurde in den vergangenen Jahren durch die Einführung einer Vielzahl von interventionellen und minimalinvasiven Techniken revolutioniert. In der vorliegenden Arbeit liefern wir eine Übersicht und Wertung des Armamentariums minimalinvasiver chirurgischer und interventioneller Techniken. Laparoskopisch-endoskopische Kombinationsverfahren und minimalinvasive Verfahren liefern viel versprechende Ergebnisse, müssen sich aber an den Ergebnissen der etablierten offenen chirurgischen Verfahren messen und erfordern eine Evaluation in größeren Serien.
Abstract
Necrosectomy of infected necroses after acute pancreatitis was revolutionized in recent years by introduction of a number of interventional and minimal invasive techniques. In the present article we review and evaluate the armamentarium of minimal invasive surgical and interventional techniques. Laparoscopic-endoscopic rendezvous manoeuvres and minimal invasive operations deliver promising results, have however to be compared to results of long standing open surgery and warrant an evaluation in larger series.
Schlüsselwörter
akute Pankreatitis - Nekrosen - minimalinvasive Chirurgie - Intervention - Übersichtsarbeit
Key words
acute pancreatitis - necrosis - minimal invasive surgery - intervention - review
Literatur
1
Baron T, Thaggard W, Morgan D. et al .
Endoscopic therapy for organized pancreatic necrosis.
Gastroenterology.
1996;
111
755-764
2
Baron T, Morgan D.
Endoscopic transgastric irrigation tube placement via PEG fordebridement of organized pancreatic necrosis.
Gastrointest Endosc.
1999;
50
574-577
3
Beger H G, Bittner R, Block S. et al .
Bacterial contamination of pancreatic necrosis. A prospective clinical study.
Gastroenterology.
1986;
91
433-438
4
Beger H G, Buchler M, Bittner R. et al .
Necrosectomy and postoperative locallavage in necrotizing pancreatitis.
Br J Surg.
1988;
75
207-212
5
Bosscha K, Hulstaert P F, Hennipman A. et al .
Fulminant acute pancreatitis and infected necrosis: results of open management of the abdomen and “plannes” reoperations.
J Am Coll Surg.
1998;
187
255-262
6
Bradley 3rd
E L.
A fifteen year experience with open drainage for infected pancreatic necrosis.
Surg Gynecol Obstet.
1993;
177
215-222
7
Buchler M W, Gloor B, Muller C A. et al .
Acute necrotizing pancreatitis: treatment strategy according to the status of infection.
Ann Surg.
2000;
232
619-626
8
Carter C, McKay C J, Imrie C.
Percutaneous necrosectomy and sinus tract endoscopy in the management of infected pacreatic necrosis: an initial experience.
Ann Surg.
2000;
232
175-180
9
Castellanos G, Pinero A, Serrano A. et al .
Infected pancreatic necrosis: translumbar approach and management with retroperitoneoscopy.
Arch Surg.
2002;
137
1060-1062
10
Connor S, Ghaneh P, Raraty M. et al .
Minimally invasive retroperitoneal pancreatic necrosectomy.
Dig Surg.
2003;
20
270-277
11
Echenique A M, Sleeman D, Yrizarry J. et al .
Percutaneous catheter-directed debridement of infected pancreatic necrosis: results in 20 patients.
J Vasc Interv Radiol.
1998;
9
565-571
12
Farkas G, Marton J, Mandi Y. et al .
Surgical strategy and management of inffected pancreatic necrosis.
Br J Surg.
1996;
83
930-933
13
Fernandez-del Castillo C, Rattner D W, Makary M A. et al .
Debridement and closed packing for the treatment of necrotizing pancreatitis.
Ann Surg.
1998;
228
676-684
14
Freeny P C, Hauptmann E, Althaus S J. et al .
Percutaneous CT-guided catheter drainage of infected acute necrotizing pancreatitis: techniques and results.
AJR Am J Roentgenol.
1998;
170
969-975
15
Gambiez L, Denimal F, Porte H. et al .
Retroperitoneal approach and endoscopic management of peripancreatic necrosis collections.
Arch Surg.
1998;
133
66-72
16
Gmeinwieser J, Feuerbach S, Zirngibl H. et al .
Percutaneous treatment of infected necrotizing pancreatitis.
Eur IHPBA.
1997;
23
575-578
17
Gouzi J L, Bloom E, Julio C. et al .
Percutaneous drainage of infected pancreatic necrosis: an alternative to surgery.
Chirurgie.
1999;
124
31-37
18
Horvath K, Kao L, Ali A. et al .
Laparoscopic assisted percutaneous drainage of infected pancreatic necrosis.
Surg Endosc.
2001;
15
677-682
19
Johnson C D, Kingsnorth A N, Imrie C W. et al .
Double blind, randomised, placebo controlled study of a platelet activating factor antagonist, lexipafant, in the treatment and prevention of organ failure in predicted severe acute pancreatitis.
Gut.
2001;
48
62-69
20
Mier J, Leon E L, Castillo A. et al .
Early versus late necrosectomy in severe nocrotizing pancreatitis.
Am J Surg.
1997;
173
71-75
21
Nieuwenhuijs V B, Besselink M G, van Minnen L P. et al .
Surgical management of acute necrotizing pancreatitis: a 13-year experience and a systematic review.
Scand J Gastroenterol Suppl.
2003;
239
111-116
22
Risse O, Auguste T, Delannoy P. et al .
Percutaneous video-assisted necrosectomy for infected pancreatic necrosis.
Gastroenterol Clin Biol.
2004;
28
868-871
23
Sarr M G, Nagorney D M, Mucha Jr P. et al .
Acute necrotizing pancreatitis: management by planned, staged pancreatic necrosectomy/debridement and delayed primary wound closure over drains.
Br J Surg.
1991;
78
576-581
24
Seewald S, Groth S, Omar S. et al .
Aggressive endoscopic therapy for pancreatic necrosis and pancreatic abscess: a new safe and effective treatment algorithm (videos).
Gastrintest Endosc.
2005;
62
92-100
25
Szentkereszty Z, Kerekes L, Hallay J. et al .
CT-guided percutaneous drainage in the treatment of acute necrotizing pancreatitis.
Magy Seb.
2001;
54
11-14
26
Tsiotos G G, Luque-de Leon E, Soreide J A. et al .
Management of necrotizing pancreatitis by repeated operative necrosectomy using a zipper technique.
Am J Surg.
1998;
175
91-98
27
Uhl W, Warshaw A, Imrie C. et al .
IAP Guidelines for the surgical management of acute pancreatitis.
Pancreatology.
2002;
2
565-573
28
British Society of Gastroenterology .
United Kingdom guidelines for the management of acute pancreatitis.
Gut.
1998;
42 (Suppl 2)
1-13
29
Zhou Z G, Zheng Y C, Shu Y. et al .
Laparoscopic management of severe aute pancreatitis.
Pancreas.
2003;
27
e46-e50
30
Zhu J, Fan X, Zhang X.
Laparoscopic treatment of severe acute pancreatitis.
Surg Endosc.
2001;
15
146-148
Priv. Doz. Dr. med. T. Keck
Abt. Allgemein- und Viszeralchirurgie mit Poliklinik Chirurgische Universitätsklinik Freiburg
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