title: [Mini-invasive approach in the treatment of acute necrotizing pancreatitis].
abstract: OBJECTIVE
  The study aims to evaluate the efficacy of percutaneous necrosectomy performed under ultrasound control and endoscopic necrosectomy trough secondary sinus track (ENTSST) using nephroscope and cystoscope.
  
  
  METHODS
  Puncture of fluid collections in the pancreas was performed under ultrasonographic control to 23 patients with acute necrotizing pancreatitis (ANP). ENTSST using nephroscope and cystoscope was performed to 47 patients after open or percutaneous necrosectomy and persistent sepsis (without satellite collection of CT).
  
  
  RESULTS
  Seventeen (74%) patients treated with percutaneous necrosectomy recovered without open surgery. Two of this group died. The average hospital stay was 42 days. Twenty-three patients required an average of two (from 1 to 4) ENTSST.
  
  
  CONCLUSIONS
  Based on our initial results we believe that the percutaneous necrosectomy and ENTSST in well selected patients might be the better choice than the open necrosectomy and postoperative lavage. Common solution of these methods has not been reached yet.
authors.forename: I
authors.initials: I
authors.lastname: Lozev
authors.forename: G
authors.initials: G
authors.lastname: Kirov
authors.forename: D
authors.initials: D
authors.lastname: Dardanov
authors.forename: N
authors.initials: N
authors.lastname: Smilov
authors.forename: B
authors.initials: B
authors.lastname: Moshev
authors.forename: R
authors.initials: R
authors.lastname: Gaidarski
mesh_terms: D000368:Aged; D020684:Cystoscopes; D004724:Endoscopy / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000601:surgery*; D019283:Pancreatitis, Acute Necrotizing / Q000601:surgery*