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Large area of walled‐off pancreatic necrosis successfully treated by endoscopic necrosectomy using a grasping‐type scissors forceps
Author(s) -
Aso Akira,
Igarashi Hisato,
Matsui Noriaki,
Ihara Eikichi,
Takaoka Takehiro,
Osoegawa Takashi,
Niina Yusuke,
Oono Takamasa,
Akahoshi Kazuya,
Nakamura Kazuhiko,
Ito Tetsuhide,
Takayanagi Ryoichi
Publication year - 2014
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.12134
Subject(s) - medicine , forceps , surgery , pancreatitis , necrosis , pleural effusion
Endoscopic necrosectomy ( EN ) for walled‐off pancreatic necrosis ( WOPN ) is less invasive than surgical treatment and has become the first choice for pancreatic abscess. EN is usually carried out with several devices including snares, baskets, and grasping forceps. Occasionally, we have encountered cases in which EN has not been satisfactorily carried out, and there is pressure for further innovation in EN . Here, we describe a case of a large area of WOPN that was successfully treated by EN with endoscopic submucosal dissection and associated techniques, which facilitated removal of necrotic tissues. A 60‐year‐old man was referred to our hospital for WOPN as a complication of necrotizing pancreatitis. As a result of his complicating conditions including ischemic heart disease, uncontrollable arrhythmia, chronic renalfailure, and persistent pleural effusion, he was deemed a poor surgical candidate. Although EN with conventional devices was carried out for five sessions, we could not remove the dense and massive necrotic tissues. At the sixth EN session, the C lutch C utter device ( F ujifilm, T okyo, J apan) was used to remove the necrotic tissues, without major complications. This is believed to be the first report of EN using the C lutch C utter for successful treatment of WOPN .