Outcomes in Endoscopic and Operative Transgastric Pancreatic Debridement
dc.contributor.author | Maatman, Thomas K. | |
dc.contributor.author | McGuire, Sean P. | |
dc.contributor.author | Flick, Katelyn F. | |
dc.contributor.author | Madison, Mackenzie K. | |
dc.contributor.author | Al-Haddad, Mohammad A. | |
dc.contributor.author | Bick, Benjamin L. | |
dc.contributor.author | Ceppa, Eugene P. | |
dc.contributor.author | DeWitt, John M. | |
dc.contributor.author | Easler, Jeffrey J. | |
dc.contributor.author | Fogel, Evan L. | |
dc.contributor.author | Gromski, Mark A. | |
dc.contributor.author | House, Michael G. | |
dc.contributor.author | Lehman, Glen A. | |
dc.contributor.author | Nakeeb, Attila | |
dc.contributor.author | Schmidt, C. Max | |
dc.contributor.author | Sherman, Stuart | |
dc.contributor.author | Watkins, James L. | |
dc.contributor.author | Zyromski, Nicholas J. | |
dc.contributor.department | Surgery, School of Medicine | en_US |
dc.date.accessioned | 2023-06-12T17:56:04Z | |
dc.date.available | 2023-06-12T17:56:04Z | |
dc.date.issued | 2021 | |
dc.description.abstract | Objectives: Select patients with anatomically favorable walled off pancreatic necrosis may be treated by endoscopic (Endo-TGD) or operative (OR-TGD) transgastric debridement (TGD). We compared our experience with these 2 approaches. Summary background data: Select necrotizing pancreatitis (NP) patients are suitable for TGD which may be accomplished endoscopically or surgically. Limited experience exists contrasting these techniques exists. Methods: Patients undergoing Endo-TGD and OR-TGD at a single, high-volume pancreatic center between 2008 and 2019 were identified from a prospective database. Patient characteristics, procedural details, and outcomes of these 2 groups were compared. Results: Among 498 NP patients undergoing necrosis intervention, 160 (32%) had TGD: 59 Endo-TGD and 101 OR-TGD. The groups were statistically similar in age, comorbidity, pancreatitis etiology, necrosis anatomy, pancreatitis severity, and timing of TGD from pancreatitis insult. OR-TGD required 1.1 ± 0.5 and Endo-TGD 3.0 ± 2.0 debridements/patient. Fewer hospital readmissions and repeat necrosis interventions, and shorter total inpatient length of stay were observed in OR-TGD patients. New-onset organ failure [Endo-TGD (13%); OR-TGD (13%); P = 1.0] was similar between groups. Hospital length of stay after TGD was significantly longer in patients undergoing Endo-TGD (13.8 ± 20.8 days) compared to OR-TGD (9.4 ± 6.1 days; P = 0.047). Mortality was 7% in Endo-TGD and 1% in OR-TGD (P = 0.04). Conclusions: Operative and endoscopic transgastric debridement achieve necrosis resolution with different temporal and procedural profiles. Clear multidisciplinary communication is essential to determine appropriate approach to individual necrotizing pancreatitis patients. | en_US |
dc.eprint.version | Author's manuscript | en_US |
dc.identifier.citation | Maatman TK, McGuire SP, Flick KF, et al. Outcomes in Endoscopic and Operative Transgastric Pancreatic Debridement. Ann Surg. 2021;274(3):516-523. doi:10.1097/SLA.0000000000004997 | en_US |
dc.identifier.uri | https://hdl.handle.net/1805/33673 | |
dc.language.iso | en_US | en_US |
dc.publisher | Wolters Kluwer | en_US |
dc.relation.isversionof | 10.1097/SLA.0000000000004997 | en_US |
dc.relation.journal | Annals of Surgery | en_US |
dc.rights | Publisher Policy | en_US |
dc.source | PMC | en_US |
dc.subject | Debridement | en_US |
dc.subject | Laparoscopy | en_US |
dc.subject | Acute necrotizing pancreatitis | en_US |
dc.title | Outcomes in Endoscopic and Operative Transgastric Pancreatic Debridement | en_US |
dc.type | Article | en_US |