Outcomes following laparoscopic internal drainage of walled off necrosis of pancreas: experience of 134 cases from a ter
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and Other Interventional Techniques
2019 SAGES ORAL
Outcomes following laparoscopic internal drainage of walled off necrosis of pancreas: experience of 134 cases from a tertiary care centre Virinder Kumar Bansal1 · Asuri Krishna1 · Om Prakash Prajapati1 · Aditya Baksi1 · Subodh Kumar1 · Pramod Garg2 · Mahesh Chandra Misra1 Received: 19 June 2019 / Accepted: 28 November 2019 © Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Introduction Internal drainage of walled of necrosis of pancreas has been considered as the standard of care. For symptomatic walled off necrosis (WON) of pancreas with the advent of laparoscopy and refinement of techniques and instrumentation, laparoscopic internal drainage is becoming the standard surgical drainage procedure for these patients. However, there is a dearth of literature regarding outcomes following laparoscopic drainage. Most of the studies have small number of patients with limited follow-up. We in this study describe our experience of laparoscopic internal drainage of walled off necrosis over the last 13 years. Materials and methods This is a retrospective analysis of a prospectively maintained database. All patients with WON undergoing laparoscopic internal drainage between January 2005 and December 2018 were included. Primary outcome measure was successful drainage. Secondary outcome measures included morbidity, hospital stay, re-intervention rate and mortality. Patients were followed up post-operatively at 1 week, 4 weeks, 3 months and then annually thereafter. Ultrasonography was done periodically for the assessment of cyst resolution. Results Between 2005 and 2018, 154 surgical drainage procedures were performed for symptomatic pseudocyst/walled off necrosis. Out of these, 134 underwent laparoscopic drainage; 129 patients (96.3%) underwent laparoscopic cystogastrostomy and 5 (3.7%) underwent laparoscopic cystojejunostomy. Majority of the patients were male (male:female = 6:1) with a mean age of 36 ± 12.9 years (range 15–58 years). The mean operative time was 94 min (range 64–144 min). There were three conversions because of intra-operative bleeding. The overall post-operative morbidity was 8.9%. The average hospital stay was 4.4 days (2–19 days). The mean duration of follow-up was 5.5 years (range 6 months–13 years). Complete cyst resolution was achieved in 95.5% (n = 128) patients. There has been no mortality till date. Conclusion In conclusion, laparoscopic internal drainage is a very effective technique for drainage of WON with an excellent success rate. Keywords Acute fluid collection · Walled off necrosis · Laparoscopic cystogastrostomy
* Asuri Krishna [email protected]
Pramod Garg [email protected]
Virinder Kumar Bansal [email protected]
Mahesh Chandra Misra [email protected]
Om Prakash Prajapati [email protected]
1
Aditya Baksi [email protected]
Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India
2
Department of Gastroenterology & Human Nutritio
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