title: Retroperitoneal endoscopic debridement for infected peripancreatic necrosis.
abstract: Standard management of infected peripancreatic necrosis consists of open surgical debridement and lavage--a traumatic intervention with substantial morbidity and mortality. As an alternative and novel approach with minimum invasiveness, we present fenestration of the gastric wall and debridement of infected necrosis by direct retroperitoneal endoscopy. In three patients, this strategy led to rapid clinical improvement and no serious complications. Transgastric endoscopic therapy may be a less traumatic alternative to surgery and should be further assessed in prospective studies.
authors.forename: H
authors.initials: H
authors.lastname: Seifert
authors.forename: T
authors.initials: T
authors.lastname: Wehrmann
authors.forename: T
authors.initials: T
authors.lastname: Schmitt
authors.forename: S
authors.initials: S
authors.lastname: Zeuzem
authors.forename: W F
authors.initials: WF
authors.lastname: Caspary
mesh_terms: D000208:Acute Disease; D000328:Adult; D003646:Debridement / Q000295:instrumentation / Q000379:methods*; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D006801:Humans; D007239:Infections / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D010179:Pancreas / Q000473:pathology / Q000601:surgery; D010192:Pancreatic Pseudocyst / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D010195:Pancreatitis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D012187:Retroperitoneal Space / Q000601:surgery*; D013158:Splenic Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D015607:Stents; D013270:Stomach / Q000473:pathology / Q000601:surgery; D013272:Stomach Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery