セッション情報 International Session8(消化器内視鏡学会・消化器病学会合同)

Recent advances in Interventional EUS 《Video》

タイトル 内IS8-2:

Endoscopic necrosecomy for infected walled-off pancreatic necrosis

演者 T. Iwai(Department of Gastroenterology of Kitasato University School of Medicine)
共同演者 M. Kida(Department of Gastroenterology of Kitasato University School of Medicine), W. Koizumi(Department of Gastroenterology of Kitasato University School of Medicine)
抄録 Background: Infected pancreatic cyst and pancreatic necrosis is the main life threatening complication in the late stage of severe acute pancreatitis. The approach to these clinical states has shifted from open surgery to endoscopic procedures such as EUS-guided cyst drainage (ECD) and/plus endoscopic necrosectomy (EN). Aim: To evaluate the efficacy and safety of ECD for pancreatic pseudocyst and EN for infected walled-off pancreatitis. Methods: From January 2001 through December 2012, pancreatic pseudocysts were treated by ECD in 43 patients. If removal of necrotic material is required, EN was performed from Feb 2008. And if the lesion is divided or too large to do EN through the gastric fistula, percutaneous EN was added. Results: Ninety one % of ECD cases were responded. As for complications, stent migration and emerging of free air and leakage of fluid were listed. One needed additional surgery. Twelve cases that underwent EN were all responded and effective. As for complications, 3 patients had active bleeding and two patients need blood transfusion, and 1 had infectious endocarditis. Conclusions: ECD and EN are effective and safe technique, but the establishment of standard procedure and the development of specialized devices are expected.
索引用語 EUS-FNA, Necrosectomy