Minimally invasive retroperitoneal pancreatic necrosectomy in the management of infected pancreatitis

• Published in: Surgical laparoscopy, endoscopy & percutaneous techniques Vol. 20; no. 1; p. e11
• Main Authors: Lakshmanan, Radhika, Iyer, Shridhar Ganpathi, Lee, Victor T W, Chang, Stephen K Y, Madhavan, Krishnakumar
• Format: Journal Article
• Language: English
• Published: United States 01.02.2010
• Subjects: Adult; Aged; Debridement - methods; Female; Humans; Length of Stay; Male; Middle Aged; Minimally Invasive Surgical Procedures; Pancreas - microbiology; Pancreas - surgery; Pancreatitis, Acute Necrotizing - drug therapy; Pancreatitis, Acute Necrotizing - microbiology; Pancreatitis, Acute Necrotizing - surgery; Retroperitoneal Space - microbiology; Retroperitoneal Space - surgery
• ISSN: 1534-4908
• DOI: 10.1097/SLE.0b013e3181c8f340

Surgical debridement is the mainstay in the management of infected pancreatic necrosis. Minimally invasive techniques have been shown to minimize surgical insult. We aim to review our recent experience with minimally invasive retroperitoneal pancreatic necrosectomy (MIRP). The medical records of consecutive patients between October 2007 and April 2008 who underwent MIRP at our hospital were reviewed. All the patients had a preoperative computed tomography-guided aspiration and positive bacteriologic culture of the peripancreatic collection. Five patients underwent MIRP during the 8-month period. Fourteen procedures were carried out, with a median of 3 (range, 1 to 5) procedures per patient. Only 1 patient required postoperative intensive care monitoring. One patient had a left renal contusion that resolved, and 2 patients developed pancreatic fistula owing to pancreatic duct disruption requiring stenting of the pancreatic duct. There were no mortalities. MIRP is a good alternative technique in the management of selected patients with infected peripancreatic necrosis.