Endoscopic necrosectomy of organized pancreatic necrosis: a currently practiced NOTES procedure.
BACKGROUND
Endoscopic necrosectomy is now an established minimally invasive method for treatment of organized pancreatic necrosis.


METHODS
Review of methods and results of endoscopic treatment of pancreatic necrosis.


RESULTS
Reports by multiple groups have demonstrated favorable results of endoscopic necrosectomy. The mortality of critically ill patients undergoing endoscopic treatment in several series is approximately 10%. Some patients will eventually also require surgery for situations such as complete pancreatic duct disruption, but even in these cases endoscopic necrosectomy is useful because pancreatic surgery can often be delayed until the patient is stable.


CONCLUSIONS
Endoscopic necrosectomy will likely assume an increasing role in the treatment of pancreatic necrosis. This should result in reduced morbidity and mortality in these critically ill patients.
Veterans Affairs Palo Alto Health Care System, Stanford University, Stanford, CA USA. shai_friedland@yahoo.com
Shai
S
Friedland
Tonya
T
Kaltenbach
Maki
M
Sugimoto
Roy
R
Soetikno
D002921:Cicatrix / Q000517:prevention & control; D016638:Critical Illness; D019723:Endoscopes; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009336:Necrosis / Q000601:surgery; D010180:Pancreatectomy / Q000379:methods; D019283:Pancreatitis, Acute Necrotizing / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D018579:Patient Selection; D011183:Postoperative Complications / Q000503:physiopathology; D012307:Risk Factors; D012680:Sensitivity and Specificity; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome