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Medicina is published by MDPI from Volume 54 Issue 1 (2018). Articles in this Issue were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence. Articles are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.
Open AccessArticle

Three-port retroperitoneoscopic necrosectomy in management of acute necrotic pancreatitis

1
Clinic of Gastroenterology, Nephrourology and Surgery, Faculty of Medicine, Vilnius University
2
Center of Abdominal Surgery, Vilnius University Hospital Santariškių Klinikos
3
Faculty of Medicine, Vilnius University, Lithuania
*
Author to whom correspondence should be addressed.
Medicina 2010, 46(3), 176; https://doi.org/10.3390/medicina46030024
Received: 1 July 2008 / Accepted: 5 March 2010 / Published: 10 March 2010
Introduction. Because of major morbidity and mortality after open surgery in acute necrotic pancreatitis, an interest in minimally invasive necrosectomy approaches has increased. We report the results of a recently developed minimally invasive technique that we adopted in 2007.
Material and methods.
This article contains a retrospective analysis of cases and description of original retroperitoneoscopic necrosectomy technique. There were eight patients aged 25–58 years, who underwent retroperitoneoscopic pancreatic necrosectomy in the Center of Abdominal Surgery, Vilnius University Hospital Santariškių Klinikos, between 2007 and 2009. All patients had at least 30% pancreatic necrosis with extensive retroperitoneal fl uid collections on the left side, proved by CT scan. Operations were performed on the 21st–56th days of illness (median, 36th day).
Results
. The mean postoperative hospital stay was 49 days (range, 14–99 days). All patients survived. Two patients underwent three additional procedures; two patients, one additional procedure due to remaining infected necrosis. Three patients had no requirement for additional procedures. One patient underwent laparotomy because of bleeding.
Conclusions
. We assume that minimally invasive techniques should be considered a first-choice surgical option in patients with acute necrotic pancreatitis, whenever it is possible. Pancreatic necrosis less than 30% with large fluid collections in the left retroperitoneal space facilitates employment of three-port retroperitoneoscopic necrosectomy.
Keywords: acute pancreatitis; necrosectomy; retroperitoneoscopy acute pancreatitis; necrosectomy; retroperitoneoscopy
MDPI and ACS Style

Šileikis, A.; Beiša, V.; Simutis, G.; Tamošiūnas, A.; Strupas, K. Three-port retroperitoneoscopic necrosectomy in management of acute necrotic pancreatitis. Medicina 2010, 46, 176.

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