ArticleSurgical endoscopy2021
Endoscopic drainage with local infusion of antibiotics to avoid necrosectomy of infected walled-off necrosis.
Article in Surgical endoscopy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 16 citations in OpenAlex.
- The Multidisciplinary Approach to Acute Necrotizing Pancreatitis.Journal of clinical medicine · 2025Review
- Infected pancreatic necrosis-Current trends in management.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2024Review
- Multicenter study of the efficacy and safety of electrocautery-enhanced lumen-apposing metal stents for the internal drainage of pancreatic fluid collections.Scientific reports · 2024Article
- Controversies in the management of acute pancreatitis: An update.World journal of clinical cases · 2023Review
- Endoscopic transluminal drainage and necrosectomy for infected necrotizing pancreatitis: Progress and challenges.World journal of clinical cases · 2023Review
- Endoscopic ultrasound drainage of pancreatic fluid collections: do we know enough about the best approach?Therapeutic advances in gastroenterology · 2023Review
- Indian College of Radiology and Imaging Consensus Guidelines on Interventions in Pancreatitis.The Indian journal of radiology & imaging · 2022Review
- A narrative review of the mechanism of acute pancreatitis and recent advances in its clinical management.American journal of translational research · 2021Review
- A narrative review of acute pancreatitis and its diagnosis, pathogenetic mechanism, and management.Annals of translational medicine · 2021Review
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Authors and funding
11 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCurrent treatment of infected pancreatic necrosis (IPN) follows a step-up approach. Our group designed a step-up protocol that associates endoscopic drainage with local infusion of antibiotics through transmural nasocystic catheter. Aim of our study was to evaluate our step-up protocol for IPN in terms of proportion of patients avoiding necrosectomy.
methodsRetrospective analysis of patients admitted with acute pancreatitis (AP) between January 2015 and December 2018. The number of patients who responded to each therapeutic step were analysed: step 1, systemic antibiotics; step 2, endoscopic transmural drainage and local infusion of antibiotics; step 3, endoscopic necrosectomy.
results1158 patients with AP were included. 110 patients (8.4%) suffered from necrotising pancreatitis; 48 of them had IPN (42.6% of necrotising pancreatitis) and were treated with systemic antibiotics. Nineteen patients (39.6% of IPN) responded and did not required any invasive therapy. Six patients with IPN on systemic antibiotics died within the first 4 weeks of disease before step 2 could be applied. Urgent surgical necrosectomy in the first 4 weeks was performed in three additional patients. Endoscopic drainage and local antibiotic therapy was performed in the remaining 20 patients; 9 (45% of them) did well and 9 patients underwent necrosectomy (18.7% of IPN). Two patients died on drainage. Overall mortality of the total cohort of AP was 2.53%
conclusionsAddition of local infusion of antibiotics to endoscopic drainage avoids the need of necrosectomy in half of patients with IPN not responding to systemic antibiotics.
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