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Sterile and Infected Pancreatic Necrosis

  • Elham Afghani
  • Vikesh K. SinghEmail author
Chapter
  • 1.8k Downloads

Abstract

Acute necrotizing pancreatitis is a complication of acute pancreatitis that carries high morbidity and mortality. The majority of patients have sterile necrosis, which can be managed conservatively. However, in contrast, patients with infected necrosis often require drainage or debridement. Two decades ago, open surgical necrosectomy was the drainage modality of choice but this has largely been replaced by minimally invasive techniques. There have been, controverssies over the use of prophylactic antibiotics to prevent infected necrosis and percutaneous aspiration of necrosis to diagnose infection. This chapter provides an overview of the diagnosis and management of necrotizing pancreatitis. The changes in terminology based on the revised Atlanta classification, current guidelines, as well as the evaluation and management of sterile and infected pancreatic necrosis are discussed in detail.

Keywords

Acute Pancreatitis Severe Acute Pancreatitis Percutaneous Drainage Pancreatic Necrosis Necrotizing Pancreatitis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Peery AF, Dellon ES, Lund J, Crockett SD, McGowan CE, Bulsiewicz WJ, et al. Burden of gastrointestinal disease in the United States: 2012 update. Gastroenterology. 2012;143:1179–87.PubMedCrossRefPubMedCentralGoogle Scholar
  2. 2.
    Wilson C, McArdle CS, Carter DC, Imrie CW. Surgical treatment of acute necrotizing pancreatitis. Br J Surg. 1988;75:1119–23.PubMedCrossRefGoogle Scholar
  3. 3.
    Wall I, Badalov N, Baradaria R, Iswara K, Li JJ, Tenner S. Decreased mortality in acute pancreatitis related to early aggressive hydration. Pancreas. 2011;40:547–50.PubMedCrossRefGoogle Scholar
  4. 4.
    De Campos T, Cequeira C, Kuryura L, Parreira JG, Solda S, Perlingeiro JA, et al. Morbimortality indicators in severe acute pancreatitis. JOP. 2008;3:690–7.Google Scholar
  5. 5.
    de Beaux AC, Palmer KR, Carter DC. Factors influencing morbidity and mortality in acute pancreatitis: an analysis of 279 cases. Gut. 1995;37:121–6.PubMedCrossRefPubMedCentralGoogle Scholar
  6. 6.
    Perez A, Whang EE, Brooks DC, Moore Jr FD, Hughes MD, Sica GT, et al. Is severity of necrotizing pancreatitis increased in extended necrosis and infected necrosis? Pancreas. 2002;25:229–33.PubMedCrossRefGoogle Scholar
  7. 7.
    Mier J, Leon E, Castillo A, Robledo F, Blanco R. Early versus late necrosectomy in severe necrotizing pancreatitis. Am J Surg. 1997;173:71–5.PubMedCrossRefGoogle Scholar
  8. 8.
    Buchler MW, Gloor B, Muller CA, Friess H, Seiler CA, Uhl W. Acute necrotizing pancreatitis: treatment strategy according to the status of infection. Ann Surg. 2000;232:619–25.PubMedCrossRefPubMedCentralGoogle Scholar
  9. 9.
    van Santvoort HC, Bakker OJ, Bollen TL, Besselink MG, Ahmen Ali U, Schrijver AM, et al. A conservative and minimally invasive approach to necrotizing pancreatitis improves outcome. Gastroenterology. 2011;141:1254–63.PubMedCrossRefGoogle Scholar
  10. 10.
    Petrov MS, Shanbhaq S, Chakraborty M, Phillips AR, Windsor JA. Organ failure and infection of pancreatic necrosis as determinants of mortality in patients with acute pancreatitis. Gastroenterology. 2010;139:813–20.PubMedCrossRefGoogle Scholar
  11. 11.
    Isenmann R, Rau B, Heger HG. Bacterial infection and extent of necrosis are determinants of organ failure in patients with acute necrotizing pancreatitis. Br J Surg. 1999;86:1020–4.PubMedCrossRefGoogle Scholar
  12. 12.
    Garg PK, Khanna S, Bohidar NP, Kapil A, Tandon RK. Incidence, spectrum, and antibiotic sensitivity pattern of bacterial infections among patients with acute pancreatitis. J Gastroenterol Hepatol. 2001;16:1055–9.PubMedCrossRefGoogle Scholar
  13. 13.
    Ashley SW, Perez A, Pierce EA, Brooks DC, Moore Jr FD, Whang EE, et al. Necrotizing pancreatitis: contemporary analysis of 99 consecutive cases. Ann Surg. 2001;234:572–9.PubMedCrossRefPubMedCentralGoogle Scholar
  14. 14.
    Bradley 3rd EL. A clinically based classification system for acute pancreatitis. Summary of the International Symposium on Acute Pancreatitis, Atlanta, GA, September 11–13, 1992. Arch Surg. 1993;128:586–90.PubMedCrossRefGoogle Scholar
  15. 15.
    Howard JM, Wagner SM. Pancreatography after recovery from massive pancreatic necrosis. Ann Surg. 1989;209:31–5.PubMedCrossRefPubMedCentralGoogle Scholar
  16. 16.
    Madry S, Fromm D. Infected retroperitoneal fat necrosis associated with acute pancreatitis. J Am Coll Surg. 1994;178:277–82.PubMedGoogle Scholar
  17. 17.
    Sakorafas GH, Tsiotos GG, Sarr MG. Extrapancreatic necrotizing pancreatitis with viable pancreas: a previously under-appreciated entity. J Am Coll Surg. 1999;188:643–8.PubMedCrossRefGoogle Scholar
  18. 18.
    Bakker OJ, van Santvoort H, Besselink MG, Boermeester MA, van Eijck C, Dejong K, et al. Extrapancreatic necrosis without pancreatic parenchymal necrosis: a separate entity in necrotizing pancreatitis. Gut. 2013;62:1475–80.PubMedCrossRefGoogle Scholar
  19. 19.
    Singh VK, Bollen TL, Wu BU, Repas K, Maurer R, Yu S, et al. An assessment of the severity of interstitial pancreatitis. Clin Gastroenterol Hepatol. 2011;9:1098–103.PubMedCrossRefGoogle Scholar
  20. 20.
    Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG, et al. Classification of acute pancreatitis – 2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62:102–11.PubMedCrossRefGoogle Scholar
  21. 21.
    Tsuji Y, Tamamoto H, Yazumi S, Watanabe Y, Matsuda K, Yamamoto H, Chiba T. Perfusion computerized tomography can predict pancreatic necrosis in early stages of severe acute pancreatitis. Clin Gastroenterol Hepatol. 2007;5:1484–92.PubMedCrossRefGoogle Scholar
  22. 22.
    Morgan DE. Imaging of acute pancreatitis and its complications. Clin Gastroenterol Hepatol. 2008;6:1077–85.PubMedCrossRefGoogle Scholar
  23. 23.
    Lecesne R, Taourel P, Bret PM, Atri M, Reinhold C. Acute pancreatitis: interobserver agreement and correlation of CT and MR cholangiopancreatoography with outcome. Radiology. 1999;211:727–35.PubMedCrossRefGoogle Scholar
  24. 24.
    Pamuklar E, Semelka RC. MR imaging of the pancreas. Magn Reson Imaging Clin N Am. 2005;13:313–30.PubMedCrossRefGoogle Scholar
  25. 25.
    Arvanitakis M, Delhaye M, De Maertelaere V, Bali M, Winant C, Coppens E, et al. Computed tomography and magnetic resonance imaging in the assessment of acute pancreatitis. Gastroenterology. 2004;126:715–23.PubMedCrossRefGoogle Scholar
  26. 26.
    Besselink MG, van Santvoort HC, Boermeester MA, et al. Timing and impact of infections in acute pancreatitis. Br J Surg. 2009;96:267–73.PubMedCrossRefGoogle Scholar
  27. 27.
    Dellinger EP, Tollado JM, Soto NE, Ashley SW, Barie PS, Dugernier T, et al. Early antibiotic treatment for severe acute necrotizing pancreatitis: a randomized, double-blind, placebo-controlled study. Ann Surg. 2007;245:674–83.PubMedCrossRefPubMedCentralGoogle Scholar
  28. 28.
    Beger HG, Bittner R, Block S, Buchler M. Bacterial contamination of pancreatic necrosis a perspective clinical study. Gastroenterology. 1986;91:433–8.PubMedGoogle Scholar
  29. 29.
    Rau BM, Bothe A, Kron M, Beger HG. Role of early multisystem organ failure as major risk factor for pancreatic infections and death in severe acute pancreatitis. Clin Gastroenterol Hepatol. 2006;4:1053–61.PubMedCrossRefGoogle Scholar
  30. 30.
    van Brunschot S, Bakker OJ, Besselink MG, Bollen TL, Fockens P, Gooszen HG, et al. Treatment of necrotizing pancreatitis. Clin Gastroenterol Hepatol. 2012;10:1190–201.PubMedCrossRefGoogle Scholar
  31. 31.
    Tenner S, Baillie J, DeWitt J, Vege SS. American College of Gastroenterology guideline: management of acute pancreatitis. Am J Gastroenterol. 2013;108:1400–15.PubMedCrossRefGoogle Scholar
  32. 32.
    Bourgaux JF, Defez C, Muller L, Vivancos J, Prudhomme M, Navarro F, et al. Infectious complications, prognostic factors and assessment of anti-infectious management of 212 consecutive patients with acute pancreatitis. Gastroenterol Clin Biol. 2007;31:431–5.PubMedCrossRefGoogle Scholar
  33. 33.
    Behrman SW, Bahr MH, Dickson PV, et al. The microbiology of secondary and postoperative pancreatic infections: implications for antimicrobial management. Arch Surg. 2011;146:613–9.PubMedCrossRefGoogle Scholar
  34. 34.
    Noor MT, Radhakrishna Y, Kocchar R, Kocchar R, Wig JD, Sinha SK, et al. Bacteriology of infection in severe acute pancreatitis. JOP. 2011;12:19–25.PubMedGoogle Scholar
  35. 35.
    Kocchar R, Ahammed SKM, Chakrabarti A, Ray P, Sinha SK, Dutta U, et al. Prevalence and outcome of fungal infection in patients with severe acute pancreatitis. J Gastroenterol Hepatol. 2009;24:743–7.CrossRefGoogle Scholar
  36. 36.
    Gloor B, Muller CA, Worni M, Stahel PF, Redaelli C, Uhl W, et al. Pancreatic infection in severe pancreatitis: the role of fungus and multiresistent organisms. Arch Surg. 2001;136:592–6.PubMedCrossRefGoogle Scholar
  37. 37.
    Connor S, Alexakis N, Neal T, Raraty M, Ghaneh P, Evans J, et al. Fungal infections but not type of bacterial infection is associated with a high mortality in primary and secondary infected pancreatic necrosis. Dig Surg. 2004;21:297–304.PubMedCrossRefGoogle Scholar
  38. 38.
    Trikudanathan G, Navaneethan U, Vege SS. Intra-abdominal fungal infections complicating acute pancreatitis: a review. Am J Gastroenterol. 2011;106:1188–92.PubMedCrossRefGoogle Scholar
  39. 39.
    Isenmann R, Schwarz M, Rau B, Trautmann M, Schober W, Beger HG. Characteristics of infection with Candida species in patients with necrotizing pancreatitis. World J Surg. 2002;26:372–6.PubMedCrossRefGoogle Scholar
  40. 40.
    Banks PA. Pro: computerized tomographic fine needle aspiration (CT-FNA) is valuable in the management of infected pancreatic necrosis. Am J Gastroenterol. 2005;100:2371–2.PubMedCrossRefGoogle Scholar
  41. 41.
    Pappas TN. Con: computerized tomographic aspiration of infected pancreatic necrosis: the opinion against its routine use. Am J Gastroenterol. 2005;100:2373–4.PubMedCrossRefGoogle Scholar
  42. 42.
    Gerzog SG, Banks PA, Robbins AH, Johnson WC, Spechler SJ, Wetzner SM, et al. Early diagnosis of pancreatic infection by computed tomography-guided aspiration. Gastroenterology. 1987;93:1315–20.Google Scholar
  43. 43.
    Rau B, Pralle U, Mayer JM, Beger HG. Role of ultrasonographically guided fine-need aspiration cytology in the diagnosis of infected pancreatic necrosis. Br J Surg. 1998;85:179–84.PubMedCrossRefGoogle Scholar
  44. 44.
    Banks PA, Gerzog SG, Langevin RE, Silverman SG, Sica GT, Hughes MD. CT-guided aspiration of suspected pancreatic infection: bacteriology and clinical outcome. Int J Pancreatol. 1995;18:265–70.PubMedGoogle Scholar
  45. 45.
    Beger HG, Buchler M, Bittner R, Oettinger W, Block S, Nevalaien T. Necrosectomy and postoperative local lavage in patients with necrotizing pancreatitis: results of a prospective clinical trial. World J Surg. 1988;12:255–62.PubMedCrossRefGoogle Scholar
  46. 46.
    Wu BU, Hwang JQ, Gardner TH, Repas K, Delee R, Yu S, et al. Lactates Ringer’s solution reduces systemic inflammation compared with saline in patients with acute pancreatitis. Clin Gastroenterol Hepatol. 2011;9:710–7.PubMedCrossRefGoogle Scholar
  47. 47.
    Warndorf MG, Kurtzman JT, Bartel MJ, Cox M, Mackenzie T, Robinson S, et al. Early fluid resuscitation reduces morbidity among patients with acute pancreatitis. Clin Gastroenterol Hepatol. 2011;9:705–9.PubMedCrossRefPubMedCentralGoogle Scholar
  48. 48.
    De Madaria E, Soler-Sala G, Sanchez-Paya J, Lopez-Font I, Martinez J, Gonez-Escolar L, et al. Influence of fluid therapy on the prognosis of acute pancreatitis: a prospective cohort study. Am J Gastroenterol. 2011;106:1843–50.CrossRefGoogle Scholar
  49. 49.
    Mao EQ, Fei J, Peng YB, Tang YQ, Zhang SD. Rapid hemodilution is associated with increases sepsis and mortality among patients with severe acute pancreatitis. Chin Med J (Engl). 2010;123:1639–44.Google Scholar
  50. 50.
    Olah A, Padavi G, Belagyi T, Nagy A, Issekutz A, Mohamed GE. Early nasojejunal feeding in acute pancreatitis is associated with a lower complication rate. Nutrition. 2002;18:259–62.PubMedCrossRefGoogle Scholar
  51. 51.
    Petrov MS, Kukosh MV, Emelyanov NV. A randomized controlled trial of enteral versus parenteral feeding in patients with predicted severe acute pancreatitis shows a significant reduction in mortality and in infected pancreatic complications with total enteral nutrition. Dig Surg. 2006;23:336–45.PubMedCrossRefGoogle Scholar
  52. 52.
    Al-Omran M, Albalawi ZH, Tashkandi MF, Al-Ansary LA. Enteral versus parenteral nutrition for acute pancreatitis. Cochrane Database Syst Rev 2010;1:CD002837.Google Scholar
  53. 53.
    Hartwig W, Maksan S-M, Foitzik T, Schmidt J, Herfarth C, Klar E. Reduction in mortality with delayed surgical therapy of severe pancreatitis. J Gastrointest Surg. 2002;6:481–7.PubMedCrossRefGoogle Scholar
  54. 54.
    Freeman ML, Werner J, van Santvoort HC, Baron TH, Besselink MG, Windsor JA, et al. Interventions for necrotizing pancreatitis: summary of a multidisciplinary consensus conference. Pancreas. 2012;41:1176–94.PubMedCrossRefGoogle Scholar
  55. 55.
    Pederzoli P, Bassi C, Vesentini S, Campedelli A. A randomized multicenter clinical trial of antibiotic prophylaxis of septic complications in acute necrotizing pancreatitis with imipenem. Surg Gynecol Obstet. 1993;176:480–3.PubMedGoogle Scholar
  56. 56.
    Saino V, Kemppaninen E, Puolakkainen P, Taavitsainen M, Kivisaari L, Valtonen V, et al. Early antibiotics treatment in acute necrotizing pancreatitis. Lancet. 1995;346:663–7.CrossRefGoogle Scholar
  57. 57.
    Xue P, Deng LH, Zhang ZD, Yang XN, Wan MH, Song B, et al. Effect of antibiotic prophylaxis on acute necrotizing pancreatitis results of a randomized controlled trial. J Gastroenterol Hepatol. 2009;24:736–42.PubMedCrossRefGoogle Scholar
  58. 58.
    Isenmann R, Runzi M, Kron M, Kahl S, Kraus D, Jung N, Maier L, et al. Prophylactic antibiotic treatment in patients with predicted severe acute pancreatitis: a placebo controlled, double-blind trial. Gastroenterology. 2004;126:997–1004.PubMedCrossRefGoogle Scholar
  59. 59.
    De Vries AC, Besselink MGH, Buskens E, Ridwan BU, Schipper M, van Erpecum KJ, et al. Randomized controlled trials of antibiotics prophylaxis in severe acute pancreatitis: relationship between methodological quality and outcome. Pancreatology. 2007;7:531–8.PubMedCrossRefGoogle Scholar
  60. 60.
    Villatoro E, Mulla M, Larvin M. Antibiotic therapy for prophylaxis against infection of pancreatic necrosis in acute pancreatitis. Cochrane Database Syst Rev. 2010;12:CD002941.Google Scholar
  61. 61.
    Berzin TM, Rocha FG, Whang EE, Mortele KJ, Ashley SW, Banks PA. Prevalence of primary fungal infections in necrotizing pancreatitis. Pancreatology. 2007;7:63–6.PubMedCrossRefGoogle Scholar
  62. 62.
    Freeny PC, Hauptmann E, Althaus SJ, Traverso LW, Sinanan M. Percutaneous CT-guided catheter drainage of infected acute necrotizing pancreatitis: techniques and results. Am J Roentgenol. 1998;170:969–75.CrossRefGoogle Scholar
  63. 63.
    Runzi M, Niebel W, Goebell H, Gerken G, Layer P. Severe acute pancreatitis: nonsurgical treatment of infected necroses. Pancreas. 2005;30:195–9.PubMedCrossRefGoogle Scholar
  64. 64.
    van Goor H, Sluiter WJ, Bleichrodt RP. Early and long term results of necrosectomy and planned re-exploration for infected necrosis. Eur J Surg. 1997;163:611–8.PubMedGoogle Scholar
  65. 65.
    Connor S, Alexakis N, Raraty MG, Ghaneh P, Evans J, Hughes M, et al. Early and late complications after pancreatic necrosectomy. Surgery. 2005;137:499–505.PubMedCrossRefGoogle Scholar
  66. 66.
    Uhl W, Warshaw A, Imrie C, Bassi C, McKay CJ, Lankisch PG, et al. IAP guidelines for the surgical management of acute pancreatitis. Pancreatology. 2002;2:565–73.PubMedCrossRefGoogle Scholar
  67. 67.
    Besselink MG, Verwer TJ, Schoenmaeckers EJ, Buskens E, Ridwan BU, Visser MR, et al. Timing of surgical intervention in necrotizing pancreatitis. Arch Surg. 2007;142:1194–201.PubMedCrossRefGoogle Scholar
  68. 68.
    Garg PK, Sharma M, Madan K, Sahni P, Banerjee D, Goyal R. Primary conservative treatment results in mortality comparable to surgery in patients with infected pancreatic necrosis. Clin Gastroenterol Hepatol. 2010;8:1089–94.PubMedCrossRefGoogle Scholar
  69. 69.
    Molli VP, Sreenivas V, Garg PK. Efficacy of conservative treatment without necrosectomy, for infected pancreatic necrosis: a systematic review and meta-analysis. Gastroenterology. 2013;144:333–40.CrossRefGoogle Scholar
  70. 70.
    van Baal MC, van Santvoort HC, Bollen TL, Bakker OJ, Besselink MG, Gooszen HG, et al. Systematic review of percutaneous catheter drainage as primary treatment for necrotizing pancreatitis. Br J Surg. 2011;98:18–27.PubMedCrossRefGoogle Scholar
  71. 71.
    Carter CR, McKay CJ, Imrie CW. Percutaneous necrosectomy and sinus tract endoscopy in the management of infected pancreatic necrosis: an initial experience. Ann Surg. 2000;232:175–80.PubMedCrossRefPubMedCentralGoogle Scholar
  72. 72.
    Connor S, Ghaneh P, Raraty M, Sutton R, Rosso E, Garvey CJ, et al. Minimally invasive retroperitoneal pancreatic necrosectomy. Dig Surg. 2003;20:270–7.PubMedCrossRefGoogle Scholar
  73. 73.
    van Santvoort HC, Besselink MG, Horvath KD, Sinanan MN, Bollen TL, van Ramshorst B, et al. Videoscopic assisted retroperitoneal debridement in infected necrotizing pancreatitis. HPB. 2007;9:156–9.PubMedCrossRefPubMedCentralGoogle Scholar
  74. 74.
    Horvath K, Freeny P, Escallon J, Heagerty P, Comstock B, Glickerman DJ, et al. Safety and efficacy of video-assisted retroperitoneal debridement for infected pancreatic collections: a multicenter, prospective, single-arm phase 2 study. Arch Surg. 2010;145:817–25.PubMedCrossRefGoogle Scholar
  75. 75.
    Baron TH, Thaggard WG, Morgan DE, Stanley RJ. Endoscopic therapy for organized pancreatic necrosis. Gastroenterology. 1996;111:755–64.PubMedCrossRefGoogle Scholar
  76. 76.
    Seifert H, Wehrmann T, Schmitt T, Zeuzem S, Caspary WF. Retroperitoneal endoscopic debridement for infected peripancreatic necrosis. Lancet. 2000;356:653–5.PubMedCrossRefGoogle Scholar
  77. 77.
    Papachristou GI, Takahashi N, Chahal P, Sarr MG, Baron TH. Peroral endoscopic drainage/debridement of walled off pancreatic necrosis. Ann Surg. 2007;245:943–51.PubMedCrossRefPubMedCentralGoogle Scholar
  78. 78.
    Gardner TB, Chahal P, Papachristou GI, Vege SS, Petersen BT, et al. A comparison of direct endoscopic necrosectomy with transmural drainage for the treatment of walled-off pancreatic necrosis. Gastrointest Endosc. 2009;69:1085–94.PubMedCrossRefGoogle Scholar
  79. 79.
    Gardner TB, Coelho-Prabhu N, Gordon SR, Gelrud A, Maple JT, Papachristou GI, et al. Direct endoscopic necrosectomy for treatment of walled-off pancreatic necrosis: results from a multicenter U.S. series. Gastrointest Endosc. 2011;73:718–26.PubMedCrossRefGoogle Scholar
  80. 80.
    Gardner TB. Endoscopic management of necrotizing pancreatitis. Gastrointest Endosc. 2012;76:1214–23.PubMedCrossRefGoogle Scholar
  81. 81.
    Seifert H, Biermer M, Schmitt W, Jurgensen C, Will U, Gerlach R, et al. Transluminal endoscopic necrosectomy after acute pancreatitis: a multicenter study with long-term follow-up (the GEPARD study). BMJ. 2009;58:1260–6.Google Scholar
  82. 82.
    Binmoeller KF. EUS-guided drainage of pancreatic fluid collections using fully covered self-expandable metal stents. Gastroenterol Hepatol. 2013;9:442–4.Google Scholar
  83. 83.
    Giovannini M, Pesenti C, Rolland AL, Moutardier V, Delpero JR. Endoscopic ultrasound guided drainage of pancreatic pseudocysts or pancreatic abscesses using a therapeutic echoendoscope. Endoscopy. 2001;33:473–7.PubMedCrossRefGoogle Scholar
  84. 84.
    Belle S, Collet P, Post S, Kaehler G. Temporary cystgastrostomy with self-expending metallic stents for pancreatic necrosis. Endoscopy. 2010;42:493–5.PubMedCrossRefGoogle Scholar
  85. 85.
    Itoi T, Nageshwar Reddy D, Yasuda I. New fully-covered self-expandable metal stent for endoscopic ultrasonography-guided intervention in infectious walled-off pancreatic necrosis (with video). J Hepatobiliary Pancreat Sci. 2013;20:403–6.PubMedCrossRefGoogle Scholar
  86. 86.
    Fabbri C, Luigiano C, Cennamo V, Polifemo AM, Barresi L, Jovine E, et al. Endoscopic ultrasound-guided transmural drainage of infected pancreatic fluid collections with placement of covered self-expanding metal stents: a case series. Endoscopy. 2012;44:429–33.PubMedCrossRefGoogle Scholar
  87. 87.
    Binmoeller KF, Shah J. A novel lumen-apposing stent for transluminal drainage of nonadherent extraintestinal fluid collections. Endoscopy. 2011;43:337–42.PubMedCrossRefGoogle Scholar
  88. 88.
    Gornals JB, De la Serna-Higuera C, Sanchez-Yague A, Loras C, Sanchez-Cantos AM, Perez-Miranda M. Endosonography-guided drainage of pancreatic fluid collections with a novel lumen-apposing stent. Surg Endosc. 2013;27:1428–34.PubMedCrossRefGoogle Scholar
  89. 89.
    Bakker OJ, van Santvoort HC, van Brunschot S, Geskus RB, Bollen TL, van Eijck CH, et al. Endoscopic transgastric vs surgical necrosectomy for infected necrotizing pancreatitis: a randomized trial. JAMA. 2012;307:1053–61.PubMedCrossRefGoogle Scholar
  90. 90.
    Ross A, Gluck M, Irani S, Hauptmann E, Fotoohi M, Siegal J, et al. Combines endoscopic and percutaneous drainage of organized pancreatic necrosis. Gastrointest Endosc. 2010;71:79–84.PubMedCrossRefGoogle Scholar
  91. 91.
    Gluck M, Ross A, Irani S, Lin O, Gan SI, Fotoohi M, et al. Dual modality drainage for symptomatic walled-off pancreatic necrosis reduced length of hospitalization, radiological procedures, and number of endoscopies compared to standard percutaneous drainage. J Gastrointest Surg. 2012;16:248–56.PubMedCrossRefGoogle Scholar
  92. 92.
    Gluck M, Ross A, Irani S, Lin O, Hauptmann E, Siegal J, et al. Endoscopic and percutaneous drainage of symptomatic walled-off pancreatic necrosis reduces hospital stay and radiographic resources. Clin Gastroenterol Hepatol. 2010;8:1083–8.PubMedCrossRefGoogle Scholar
  93. 93.
    van Santvoort HC, Besselink MG, Bakker OJ, Hofker HS, Boermeester MA, Dejong CH, et al. A step up approach or open necrosectomy for necrotizing pancreatitis. N Engl J Med. 2010;362:1491–502.PubMedCrossRefGoogle Scholar

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© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Department of GastroenterologyJohns Hopkins HospitalBaltimoreUSA
  2. 2.Division of GastroenterologyPancreatic islet autotransplantation programBaltimoreUSA

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