Minimally invasive retroperitoneal pancreatic necrosectomy in the management of infected pancreatitis.
BACKGROUND
Surgical debridement is the mainstay in the management of infected pancreatic necrosis. Minimally invasive techniques have been shown to minimize surgical insult. We aim to review our recent experience with minimally invasive retroperitoneal pancreatic necrosectomy (MIRP).


METHODS
The medical records of consecutive patients between October 2007 and April 2008 who underwent MIRP at our hospital were reviewed. All the patients had a preoperative computed tomography-guided aspiration and positive bacteriologic culture of the peripancreatic collection.


RESULTS
Five patients underwent MIRP during the 8-month period. Fourteen procedures were carried out, with a median of 3 (range, 1 to 5) procedures per patient. Only 1 patient required postoperative intensive care monitoring. One patient had a left renal contusion that resolved, and 2 patients developed pancreatic fistula owing to pancreatic duct disruption requiring stenting of the pancreatic duct. There were no mortalities.


CONCLUSIONS
MIRP is a good alternative technique in the management of selected patients with infected peripancreatic necrosis.
Lakshmanan
Radhika
R
Division of Hepatobiliary & Pancreatic Surgery, Liver Transplant Programme, Department of Surgery, National University Hospital, Singapore.
Iyer
Shridhar Ganpathi
SG
Lee
Victor T W
VT
Chang
Stephen K Y
SK
Madhavan
Krishnakumar
K
D000328:Adult; D000368:Aged; D003646:Debridement / Q000379:methods; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D010179:Pancreas / Q000382:microbiology / Q000601:surgery*; D019283:Pancreatitis, Acute Necrotizing / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery*; D012187:Retroperitoneal Space / Q000382:microbiology / Q000601:surgery