An experience of video-assisted retroperitoneal debridement
https://doi.org/10.16931/1995-5464.2018493-99
Abstract
Aim. To clarify the indications for video-assisted retroperitoneal debridement at the late stage of pancreatic necrosis. Material and methods. Acute pancreatitis was diagnosed in 1468 patients throughout 2012-2018. Severe destructive pancreatic necrosis occurred in 364 (24.8%) patients. Infected pancreatic necrosis needed for surgical treatment in 264 cases. We used video-assisted retroperitoneal debridement in 20 patients (8.1%).
Results. Video-assisted retroperitoneal debridement was not associated with “open” surgery in 6 patients. There were 2-6 redo VARD procedures per patient. We diagnosed the “left-sided” and “right-sided” models of pancreas and peripancreatic space infiltrationin 4 and 2 patients, respectively. There were 14 patients who needed an “open” surgery besides video-assisted retroperitoneal debridement due to advanced inflammation. Bleeding was the only complication and occurred in 2 patients. There was 1 unfavorable outcome.
Conclusion. Video-assisted retroperitoneal debridement is an effective minimally invasive approach of debridement. Video-assisted retroperitoneal debridement combined with percutaneous catheter drainage is preferable for “leftsided” and “right-sided” infiltration of pancreas and peripancreatic tissue. It is advisable to combine video-assisted retroperitoneal debridement with open surgery for “mixed model” of infiltration.
About the Authors
A. V. Shabunin
Russian Medical Academy of Postgraduate Education of Healthcare Ministry of the Russian Federation; Botkin Municipal Clinical Hospital of Moscow Healthcare Department
Russian Federation
Russian Federation
Aleksey V. Shabunin — Doct. of Med. Sci., Professor, Corresponding-member of RAS, Head of the Chair of Surgery of RMA PE, Chief Physician of Botkin MCHof Moscow HD, Chief Surgeon of Moscow Healthcare Department.
2/11, 1, Barrikadnaya str., Moscow, 125933; 5, 2-nd Botkinskiy passage, Moscow, 125284
A. Yu. Lukin
Russian Medical Academy of Postgraduate Education of Healthcare Ministry of the Russian Federation; Botkin Municipal Clinical Hospital of Moscow Healthcare Department
Russian Federation
Russian Federation
Andrey Yu. Lukin — Cand. of Med. Sci., Associate Professor of the Chair of Surgery of RMA PE, Deputy Chief Physician for Outpatient Care of Botkin MCHof Moscow HD.
2/11, 1, Barrikadnaya str., Moscow, 125933; 5, 2-nd Botkinskiy passage, Moscow, 125284
D. V. Shikov
Botkin Municipal Clinical Hospital of Moscow Healthcare Department
Russian Federation
Russian Federation
Dmitry V. Shikov — Cand. of Med. Sci., Head of Surgical Unit of Emergency Surgery.
5, 2-nd Botkinskiy passage, Moscow, 125284
A. A. Kolotilshchikov
Russian Medical Academy of Postgraduate Education of Healthcare Ministry of the Russian Federation; Botkin Municipal Clinical Hospital of Moscow Healthcare Department
Russian Federation
Russian Federation
Andrey A. Kolotilshchikov — Postgraduate Student of the Chair of Surgery of RMA PE, Surgeon of Botkin MCHof Moscow HD.
Apt. 222, 2-1, Grishina str., Moscow, 121354, Phone: +7964-597-70-53
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Review
For citations:
Shabunin A.V., Lukin A.Yu., Shikov D.V., Kolotilshchikov A.A. An experience of video-assisted retroperitoneal debridement. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2018;23(4):93-99. (In Russ.) https://doi.org/10.16931/1995-5464.2018493-99
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