Othman Mohamed O, Elhanafi Sherif, Saadi Mohammed, Yu Christine, Davis Brian R
Gastroenterology and Hepatology Division, Baylor College of Medicine, Houston, TX, USA.
Department of Medicine, Texas Tech University Health Sciences Center, Paul L. Foster School of Medicine, El Paso, TX, USA.
Diagn Ther Endosc. 2017;2017:7145803. doi: 10.1155/2017/7145803. Epub 2017 Sep 5.
Walled-off pancreatic necrosis (WOPN) is a major complication of acute pancreatitis. We hypothesized that an extended (2 cm) cystogastrostomy opening combined with hydrogen peroxide irrigation can increase the success of endoscopic necrosectomy and decrease the number of required endoscopic interventions. The aim of the study is to assess the safety and feasibility of the technique in the management of WOPN.
This is a retrospective chart review of all cases that underwent EUS with extended cystogastrostomy and hydrogen peroxide irrigation prior to necrosectomy in a tertiary referral medical center. Clinical success was defined as complete resolution of the cyst cavity or a cyst cavity less than 2 cm in size on follow-up imaging.
19 patients satisfied the inclusion criteria. The mean size of the walled-off cavity was 11 + 0.9 cm. Technical success of the procedure was 100%. The median number of necrosectomy sessions was 2 (range 1 to 7). Cavity resolution was noted in 18 out of 19 patients resulting in a clinical success of 94.7%. The median follow-up period was 12 months. The adverse events rate in our cohort was 15.7%.
Extended cystogastrostomy coupled with hydrogen peroxide irrigation of WOPN cavity is safe and feasible.
包裹性胰腺坏死（WOPN）是急性胰腺炎的一种主要并发症。我们假设扩大（2厘米）的囊肿胃造口术开口并结合过氧化氢冲洗可提高内镜坏死组织清除术的成功率，并减少所需的内镜干预次数。本研究的目的是评估该技术在WOPN治疗中的安全性和可行性。
这是一项对在一家三级转诊医疗中心接受内镜超声引导下扩大囊肿胃造口术及过氧化氢冲洗后进行坏死组织清除术的所有病例的回顾性图表审查。临床成功定义为随访影像显示囊肿腔完全消失或囊肿腔大小小于2厘米。
19例患者符合纳入标准。包裹性腔的平均大小为11 + 0.9厘米。该手术的技术成功率为100%。坏死组织清除术的中位次数为2次（范围1至7次）。19例患者中有18例囊肿腔消失，临床成功率为94.7%。中位随访期为12个月。我们队列中的不良事件发生率为15.7%。
扩大囊肿胃造口术联合WOPN腔过氧化氢冲洗是安全可行的。
