title: Minimally invasive retroperitoneal pancreatic necrosectomy.
abstract: BACKGROUND
  This article describes a case series outlining the experience and results of the retroperitoneal minimally invasive pancreatic necrosectomy (MIPN) procedure performed by, or done under the supervision of, a single surgeon.
  
  
  METHODS
  All data of the patients who underwent MIPN from 2006 to 2008 were entered into a prospectively maintained, computerized database.
  
  
  RESULTS
  A total of 93 MIPN procedures were performed on 32 patients. All patients had severe acute pancreatitis. The median number of MIPN procedures per patient was 3. Only 6 patients needed intensive care unit (ICU) admission after MIPN. There were 15 complications, which included bleeding requiring transfusion (n = 3), bowel fistulae (n = 7), thromboembolic events (n = 2) and acute myocardial infarction (n = 3). Four patients died after the procedure (13%); 1 died of ongoing multiorgan failure in spite of the MIPN. Four patients developed pancreatic pseudocysts within the follow-up period of 2 years. Three of these patients required intervention.
  
  
  CONCLUSIONS
  This case series demonstrates that MIPN can be performed with acceptable morbidity and mortality and with good end results. The ICU dependency after the procedure is minimal. As seen in this series, multiple MIPNs may be needed to eradicate the necrosis satisfactorily. and IAP.
authors: School of Surgery, The University of Western Australia, Perth, W.A., Australia. hairulahmad@gmail.com
authors: Hairul A
authors: HA
authors: Ahmad
authors: Inian
authors: I
authors: Samarasam
authors: Jeffrey M
authors: JM
authors: Hamdorf
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D010179:Pancreas / Q000601:surgery*; D019283:Pancreatitis, Acute Necrotizing / Q000401:mortality / Q000601:surgery*; D011183:Postoperative Complications; D011446:Prospective Studies; D012187:Retroperitoneal Space / Q000601:surgery; D015996:Survival Rate; D014904:Western Australia / Q000453:epidemiology