Walled-off pankreatik nekroz tedavisinde endoskopik ultrasonografi eşliğinde endoskopik nekrozektomi: Olgu sunumu

Öz

Walled-off pankreatik nekroz, akut nekrotizan pankreatitin geç aşamasında gelişen ciddi bir lokal komplikasyondur. Nekrotik içerik enfekte olduğunda, hayatı tehdit eden bir komplikasyon haline gelir. Hastaların yarısında basınç, enfeksiyon, mide çıkış ve biliyer obstrüksiyonu ile ilişkili semptomlar gelişir. Semptomatik hastalarda organize nekrotik materyalin debridmanı gerekir. Eskiden, walled-off pankreatik nekrozun standart tedavisi açık cerrahi yöntem olsa da yüksek morbidite ve mortalite ile ilişkilidir. Bu nedenle, radyolojik ve endoskopik gibi minimal invaziv yöntemlerin ortaya çıkmasıyla açık cerrahinin rolü giderek azalmıştır. Günümüzde özellikle endoskopik ultrasonografi ile birlikte endoskopik teknikler ve aksesuarlardaki gelişmeler, peripankreatik sıvı koleksiyonlarının endoskopik tedavilerinde devrim yaratmıştır. Diğer yöntemlere göre daha düşük morbidite, mortalite ve hastanede kalış süresi ile ilişkili olan endoskopik yöntemler giderek daha çok tercih edilmektedir. Bu yazıda, endoskopik ultrasonografi eşliğinde transluminal drenaj ve endoskopik nekrozektomi yapılan walled-off pankreatik nekroz olgusunu sunuyoruz.

Anahtar Kelimeler

• Walled-off pankreatik nekroz
• endoskopik nekrozektomi
• endoskopik ultrasonografi

Endoscopic ultrasonography guided endoscopic necrosectomy in the treatment of walled-off pancreatic necrosis: Case report

Öz

In the late stages of acute necrotizing pancreatitis, walled-off pancreatic necrosis is a serious local complication. Infection of the necrotic component of walled-off pancreatic necrosis can result in life-threatening complications. Half of the patients may develop symptoms related to pressure, infection, gastric outlet, and biliary obstruction. Moreover, organized necrotic material should be drained from symptomatic patients. In the early years, while open surgery is the standard treatment for walled-off pancreatic necrosis, it is associated with a rate of high morbidity and mortality. As a result, the use of open surgery has declined as less invasive methods, such as radiological and endoscopic procedures, have become more common. In recent years, endoscopic techniques and accessories, especially endoscopic ultrasonography, have revolutionized the endoscopic treatment of peripancreatic fluid collections. Endoscopic methods are favored over other methods because they are associated with lower morbidity, mortality, and hospital stay. In this case report, we present a patient with walled-off pancreatic necrosis who underwent endoscopic ultrasonography -guided transluminal drainage and endoscopic necrosectomy.

Anahtar Kelimeler

• Walled-off pancreatic necrosis
• endoscopic necrosectomy
• endoscopic ultrasonography

Kaynakça

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