Open AccessAn experience of video-assisted retroperitoneal debridement
Author(s) -
А. В. Шабунин,
А. Ю. Лукин,
Д. В. Шиков,
А. А. Колотильщиков
Publication year - 2019
Publication title -
annaly hirurgičeskoj gepatologii
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.138
H-Index - 1
eISSN - 2408-9524
pISSN - 1995-5464
DOI - 10.16931/1995-5464.2018493-99
Subject(s) - medicine , debridement (dental) , surgery , percutaneous , retroperitoneal space , acute pancreatitis , pancreas
Aim. To clarify the indications for video-assisted retroperitoneal debridement at the late stage of pancreatic necrosis. Material and methods. Acute pancreatitis was diagnosed in 1468 patients throughout 2012-2018. Severe destructive pancreatic necrosis occurred in 364 (24.8%) patients. Infected pancreatic necrosis needed for surgical treatment in 264 cases. We used video-assisted retroperitoneal debridement in 20 patients (8.1%). Results . Video-assisted retroperitoneal debridement was not associated with “open” surgery in 6 patients. There were 2-6 redo VARD procedures per patient. We diagnosed the “left-sided” and “right-sided” models of pancreas and peripancreatic space infiltrationin 4 and 2 patients, respectively. There were 14 patients who needed an “open” surgery besides video-assisted retroperitoneal debridement due to advanced inflammation. Bleeding was the only complication and occurred in 2 patients. There was 1 unfavorable outcome. Conclusion. Video-assisted retroperitoneal debridement is an effective minimally invasive approach of debridement. Video-assisted retroperitoneal debridement combined with percutaneous catheter drainage is preferable for “leftsided” and “right-sided” infiltration of pancreas and peripancreatic tissue. It is advisable to combine video-assisted retroperitoneal debridement with open surgery for “mixed model” of infiltration.