Laparoendoscopic Cystogastric Bypass of a Pancreatic Necrosis: Case Report and Surgical Technique

Luis Miguel Carrillo; Claudia Teresa Barba-Valadez; David Ramirez-Reyes; Jose Augusto Rodriguez-Osuna; Cristina Elizabeth Mora-Montoya; Jesus Alejandro Olvera-Rodriguez; Laura Yazmin Gutierrez-Gutierrez; Jacaranda Herrera-Gutierrez

doi:doi:10.11648/j.js.20221005.14

Laparoendoscopic Cystogastric Bypass of a Pancreatic Necrosis: Case Report and Surgical Technique

Luis Miguel Carrillo, Claudia Teresa Barba-Valadez, David Ramirez-Reyes, Jose Augusto Rodriguez-Osuna, Cristina Elizabeth Mora-Montoya, Jesus Alejandro Olvera-Rodriguez, Laura Yazmin Gutierrez-Gutierrez, Jacaranda Herrera-Gutierrez

Published in Journal of Surgery (Volume 10, Issue 5)

Received: 26 July 2022 Accepted: 9 August 2022 Published: 11 October 2022

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Abstract

The incidence of acute pancreatitis (AP) is increasing, up to 0.7 hospitalizations per 1,000 inhabitants in the U.S. In 80% of patients, AP is mild and self-limited, but up to 20% of patients may have a severe necrotizing course, responsible for substantial morbidity and a mortality rate of up to 27%. The main cause of death is necrosis infection, which is associated with a poor prognosis with a mortality of 15% to 39%. Until very recently, the gold standard for treating infected necrosis used to be surgical necrosectomy by laparotomy. This procedure provides wide access to infected necrosis but is highly invasive and is associated with morbidity rates of 34% to 95% and mortality rates of 11% to 39%. Alternative methods primarily involve debridement using retroperitoneal, laparoscopic, endoscopic, or combinations of these. They share the common goal of avoiding laparotomy and together are known as "minimally invasive necrosectomy." These techniques continue to evolve and undergo refinement. To date there is no evidence or randomized trials comparing these techniques with traditional “open” necrosectomy or, equally important, comparing different minimally invasive necrosectomy techniques with each other. This presents a problem for surgeons dealing with patients with pancreatic necrosis as they need to consult the available evidence to guide the selection of their treatment. This case provides a concise but general description of a minimally invasive approach to a pancreatic pseudocyst in a man with a history of alcoholic pancreatitis, with special reference to the surgical technique, the postoperative result and, above all, to point out the benefits of this type of approach.

Published in	Journal of Surgery (Volume 10, Issue 5)
DOI	10.11648/j.js.20221005.14
Page(s)	164-167
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Pancreatitis, Cystogastric Bypass, Minimally Invasive

References

[1]	Cao F, Duan N, Gao C, Li A, Li F. One-step verse step-up laparoscopic-assisted necrosectomy for infected pancreatic necrosis. Dig Surg. 2020; 37 (3): 211–9.
[2]	Driedger M, Zyromski NJ, Visser BC, Jester A, Sutherland FR, Nakeeb A, Dixon E, Dua MM, House MG, Worhunsky DJ, et al. Surgical transgastric necrosectomy for necrotizing pancreatitis: a single-stage procedure for walled-off pancreatic necrosis. Ann Surg. 2020; 271 (1): 163–8.
[3]	Baron TH, DiMaio CJ, Wang AY, Morgan KA. American Gastroenterological Association clinical practice update: management of pancreatic necrosis. Gastroenterology. 2020; 158 (1): 67-75 e61.
[4]	Tan V, Charachon A, Lescot T, Chafaï N, Le Baleur Y, Delchier J et al. Endoscopic transgastric versus surgical necrosectomy in infected pancreatic necrosis. 2014; 38 (6): 760-766.
[5]	Babu B, Siriwardena A. Current status of minimally invasive necrosectomy for post-inflammatory pancreatic necrosis. HPB. 2009; 11 (2): 96-102.
[6]	Habashi S, Draganov P. Pancreatic pseudocyst. World Journal of Gastroenterology. 2009; 15 (1): 38-47.
[7]	Barba VCT, López RJL, Barba VLA, et al. Laparoscopic transgastric pancreatic necrosectomy. Report of a case and bibliographic review. Mexican Journal of Endoscopic Surgery. 2013; 14 (4): 200-205.
[8]	Pan G, Wan M, Xie K, Li W, Hu W, Liu X et al. Classification and Management of Pancreatic Pseudocysts. Medicine. 2015; 94 (24): e960.
[9]	Warshaw A. Improving the Treatment of Necrotizing Pancreatitis — A Step Up. New England Journal of Medicine. 2010; 362 (16): 1535-1537.
[10]	Bugiantella W, Rondelli F, Boni M, Stella P, Polistena A, Sanguinetti A et al. Necrotizing pancreatitis: A review of the interventions. International Journal of Surgery. 2016; 28 (1): S163-S171.
[11]	Baron T, DiMaio C, Wang A, Morgan K. American Gastroenterological Association Clinical Practice Update: Management of Pancreatic Necrosis. Gastroenterology. 2019; 158 (1): 67-75.e1.
[12]	Driedger M, Zyromski N, Visser B, Jester A, Sutherland F, Nakeeb A et al. Surgical Transgastric Necrosectomy for Necrotizing Pancreatitis. Annals of Surgery. 2020; 271 (1): 163-168.
[13]	Sorrentino L, Chiara O, Mutignani M, Sammartano F, Brioschi P, Cimbanassi S. Combined totally mini-invasive approach in necrotizing pancreatitis: a case report and systematic literature review. World Journal of Emergency Surgery. 2017; 12 (1).
[14]	Van Santvoort H, Besselink M, Bakker O, Hofker H, Boermeester M, Dejong C et al. A Step-up Approach or Open Necrosectomy for Necrotizing Pancreatitis. New England Journal of Medicine. 2010; 362 (16): 1491-1502.
[15]	Worhunsky D, Qadan M, Dua M, Park W, Poultsides G, Norton J et al. Laparoscopic Transgastric Necrosectomy for the Management of Pancreatic Necrosis. Journal of the American College of Surgeons. 2014; 219 (4): 735-743.

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APA Style

Luis Miguel Carrillo, Claudia Teresa Barba-Valadez, David Ramirez-Reyes, Jose Augusto Rodriguez-Osuna, Cristina Elizabeth Mora-Montoya, et al. (2022). Laparoendoscopic Cystogastric Bypass of a Pancreatic Necrosis: Case Report and Surgical Technique. Journal of Surgery, 10(5), 164-167. https://doi.org/10.11648/j.js.20221005.14

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ACS Style

Luis Miguel Carrillo; Claudia Teresa Barba-Valadez; David Ramirez-Reyes; Jose Augusto Rodriguez-Osuna; Cristina Elizabeth Mora-Montoya, et al. Laparoendoscopic Cystogastric Bypass of a Pancreatic Necrosis: Case Report and Surgical Technique. J. Surg. 2022, 10(5), 164-167. doi: 10.11648/j.js.20221005.14

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AMA Style

Luis Miguel Carrillo, Claudia Teresa Barba-Valadez, David Ramirez-Reyes, Jose Augusto Rodriguez-Osuna, Cristina Elizabeth Mora-Montoya, et al. Laparoendoscopic Cystogastric Bypass of a Pancreatic Necrosis: Case Report and Surgical Technique. J Surg. 2022;10(5):164-167. doi: 10.11648/j.js.20221005.14

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@article{10.11648/j.js.20221005.14,
  author = {Luis Miguel Carrillo and Claudia Teresa Barba-Valadez and David Ramirez-Reyes and Jose Augusto Rodriguez-Osuna and Cristina Elizabeth Mora-Montoya and Jesus Alejandro Olvera-Rodriguez and Laura Yazmin Gutierrez-Gutierrez and Jacaranda Herrera-Gutierrez},
  title = {Laparoendoscopic Cystogastric Bypass of a Pancreatic Necrosis: Case Report and Surgical Technique},
  journal = {Journal of Surgery},
  volume = {10},
  number = {5},
  pages = {164-167},
  doi = {10.11648/j.js.20221005.14},
  url = {https://doi.org/10.11648/j.js.20221005.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20221005.14},
  abstract = {The incidence of acute pancreatitis (AP) is increasing, up to 0.7 hospitalizations per 1,000 inhabitants in the U.S. In 80% of patients, AP is mild and self-limited, but up to 20% of patients may have a severe necrotizing course, responsible for substantial morbidity and a mortality rate of up to 27%. The main cause of death is necrosis infection, which is associated with a poor prognosis with a mortality of 15% to 39%. Until very recently, the gold standard for treating infected necrosis used to be surgical necrosectomy by laparotomy. This procedure provides wide access to infected necrosis but is highly invasive and is associated with morbidity rates of 34% to 95% and mortality rates of 11% to 39%. Alternative methods primarily involve debridement using retroperitoneal, laparoscopic, endoscopic, or combinations of these. They share the common goal of avoiding laparotomy and together are known as "minimally invasive necrosectomy." These techniques continue to evolve and undergo refinement. To date there is no evidence or randomized trials comparing these techniques with traditional “open” necrosectomy or, equally important, comparing different minimally invasive necrosectomy techniques with each other. This presents a problem for surgeons dealing with patients with pancreatic necrosis as they need to consult the available evidence to guide the selection of their treatment. This case provides a concise but general description of a minimally invasive approach to a pancreatic pseudocyst in a man with a history of alcoholic pancreatitis, with special reference to the surgical technique, the postoperative result and, above all, to point out the benefits of this type of approach.},
 year = {2022}
}

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TY  - JOUR
T1  - Laparoendoscopic Cystogastric Bypass of a Pancreatic Necrosis: Case Report and Surgical Technique
AU  - Luis Miguel Carrillo
AU  - Claudia Teresa Barba-Valadez
AU  - David Ramirez-Reyes
AU  - Jose Augusto Rodriguez-Osuna
AU  - Cristina Elizabeth Mora-Montoya
AU  - Jesus Alejandro Olvera-Rodriguez
AU  - Laura Yazmin Gutierrez-Gutierrez
AU  - Jacaranda Herrera-Gutierrez
Y1  - 2022/10/11
PY  - 2022
N1  - https://doi.org/10.11648/j.js.20221005.14
DO  - 10.11648/j.js.20221005.14
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 164
EP  - 167
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.20221005.14
AB  - The incidence of acute pancreatitis (AP) is increasing, up to 0.7 hospitalizations per 1,000 inhabitants in the U.S. In 80% of patients, AP is mild and self-limited, but up to 20% of patients may have a severe necrotizing course, responsible for substantial morbidity and a mortality rate of up to 27%. The main cause of death is necrosis infection, which is associated with a poor prognosis with a mortality of 15% to 39%. Until very recently, the gold standard for treating infected necrosis used to be surgical necrosectomy by laparotomy. This procedure provides wide access to infected necrosis but is highly invasive and is associated with morbidity rates of 34% to 95% and mortality rates of 11% to 39%. Alternative methods primarily involve debridement using retroperitoneal, laparoscopic, endoscopic, or combinations of these. They share the common goal of avoiding laparotomy and together are known as "minimally invasive necrosectomy." These techniques continue to evolve and undergo refinement. To date there is no evidence or randomized trials comparing these techniques with traditional “open” necrosectomy or, equally important, comparing different minimally invasive necrosectomy techniques with each other. This presents a problem for surgeons dealing with patients with pancreatic necrosis as they need to consult the available evidence to guide the selection of their treatment. This case provides a concise but general description of a minimally invasive approach to a pancreatic pseudocyst in a man with a history of alcoholic pancreatitis, with special reference to the surgical technique, the postoperative result and, above all, to point out the benefits of this type of approach.
VL  - 10
IS  - 5
ER  -

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Author Information

Luis Miguel Carrillo

Department of General Surgery, Centenario Hospital Miguel Hidalgo, Aguascalientes, Mexico
Claudia Teresa Barba-Valadez

Department of General Surgery, Centenario Hospital Miguel Hidalgo, Aguascalientes, Mexico
David Ramirez-Reyes

Department of General Surgery, Centenario Hospital Miguel Hidalgo, Aguascalientes, Mexico
Jose Augusto Rodriguez-Osuna

Department of Advanced Laparoscopic Surgery, Civil Hospital of Guadalajara “Juan I. Menchaca”, Guadalajara, Mexico
Cristina Elizabeth Mora-Montoya

University Health Sciences Center, University of Guadalajara, Guadalajara, Mexico
Jesus Alejandro Olvera-Rodriguez

School of Medicine, University Mexico America of North, Reynosa, Mexico
Laura Yazmin Gutierrez-Gutierrez

School of Medicine, Autonomous University of Aguascalientes, Aguascalientes, Mexico
Jacaranda Herrera-Gutierrez

School of Medicine, Benemérita Autonomous University of Puebla, Puebla, Mexico

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Plain Text BibTeX RIS

APA Style

Luis Miguel Carrillo, Claudia Teresa Barba-Valadez, David Ramirez-Reyes, Jose Augusto Rodriguez-Osuna, Cristina Elizabeth Mora-Montoya, et al. (2022). Laparoendoscopic Cystogastric Bypass of a Pancreatic Necrosis: Case Report and Surgical Technique. Journal of Surgery, 10(5), 164-167. https://doi.org/10.11648/j.js.20221005.14

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ACS Style

Luis Miguel Carrillo; Claudia Teresa Barba-Valadez; David Ramirez-Reyes; Jose Augusto Rodriguez-Osuna; Cristina Elizabeth Mora-Montoya, et al. Laparoendoscopic Cystogastric Bypass of a Pancreatic Necrosis: Case Report and Surgical Technique. J. Surg. 2022, 10(5), 164-167. doi: 10.11648/j.js.20221005.14

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AMA Style

Luis Miguel Carrillo, Claudia Teresa Barba-Valadez, David Ramirez-Reyes, Jose Augusto Rodriguez-Osuna, Cristina Elizabeth Mora-Montoya, et al. Laparoendoscopic Cystogastric Bypass of a Pancreatic Necrosis: Case Report and Surgical Technique. J Surg. 2022;10(5):164-167. doi: 10.11648/j.js.20221005.14

Copy | Download

@article{10.11648/j.js.20221005.14,
  author = {Luis Miguel Carrillo and Claudia Teresa Barba-Valadez and David Ramirez-Reyes and Jose Augusto Rodriguez-Osuna and Cristina Elizabeth Mora-Montoya and Jesus Alejandro Olvera-Rodriguez and Laura Yazmin Gutierrez-Gutierrez and Jacaranda Herrera-Gutierrez},
  title = {Laparoendoscopic Cystogastric Bypass of a Pancreatic Necrosis: Case Report and Surgical Technique},
  journal = {Journal of Surgery},
  volume = {10},
  number = {5},
  pages = {164-167},
  doi = {10.11648/j.js.20221005.14},
  url = {https://doi.org/10.11648/j.js.20221005.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20221005.14},
  abstract = {The incidence of acute pancreatitis (AP) is increasing, up to 0.7 hospitalizations per 1,000 inhabitants in the U.S. In 80% of patients, AP is mild and self-limited, but up to 20% of patients may have a severe necrotizing course, responsible for substantial morbidity and a mortality rate of up to 27%. The main cause of death is necrosis infection, which is associated with a poor prognosis with a mortality of 15% to 39%. Until very recently, the gold standard for treating infected necrosis used to be surgical necrosectomy by laparotomy. This procedure provides wide access to infected necrosis but is highly invasive and is associated with morbidity rates of 34% to 95% and mortality rates of 11% to 39%. Alternative methods primarily involve debridement using retroperitoneal, laparoscopic, endoscopic, or combinations of these. They share the common goal of avoiding laparotomy and together are known as "minimally invasive necrosectomy." These techniques continue to evolve and undergo refinement. To date there is no evidence or randomized trials comparing these techniques with traditional “open” necrosectomy or, equally important, comparing different minimally invasive necrosectomy techniques with each other. This presents a problem for surgeons dealing with patients with pancreatic necrosis as they need to consult the available evidence to guide the selection of their treatment. This case provides a concise but general description of a minimally invasive approach to a pancreatic pseudocyst in a man with a history of alcoholic pancreatitis, with special reference to the surgical technique, the postoperative result and, above all, to point out the benefits of this type of approach.},
 year = {2022}
}

Copy | Download

TY  - JOUR
T1  - Laparoendoscopic Cystogastric Bypass of a Pancreatic Necrosis: Case Report and Surgical Technique
AU  - Luis Miguel Carrillo
AU  - Claudia Teresa Barba-Valadez
AU  - David Ramirez-Reyes
AU  - Jose Augusto Rodriguez-Osuna
AU  - Cristina Elizabeth Mora-Montoya
AU  - Jesus Alejandro Olvera-Rodriguez
AU  - Laura Yazmin Gutierrez-Gutierrez
AU  - Jacaranda Herrera-Gutierrez
Y1  - 2022/10/11
PY  - 2022
N1  - https://doi.org/10.11648/j.js.20221005.14
DO  - 10.11648/j.js.20221005.14
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 164
EP  - 167
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.20221005.14
AB  - The incidence of acute pancreatitis (AP) is increasing, up to 0.7 hospitalizations per 1,000 inhabitants in the U.S. In 80% of patients, AP is mild and self-limited, but up to 20% of patients may have a severe necrotizing course, responsible for substantial morbidity and a mortality rate of up to 27%. The main cause of death is necrosis infection, which is associated with a poor prognosis with a mortality of 15% to 39%. Until very recently, the gold standard for treating infected necrosis used to be surgical necrosectomy by laparotomy. This procedure provides wide access to infected necrosis but is highly invasive and is associated with morbidity rates of 34% to 95% and mortality rates of 11% to 39%. Alternative methods primarily involve debridement using retroperitoneal, laparoscopic, endoscopic, or combinations of these. They share the common goal of avoiding laparotomy and together are known as "minimally invasive necrosectomy." These techniques continue to evolve and undergo refinement. To date there is no evidence or randomized trials comparing these techniques with traditional “open” necrosectomy or, equally important, comparing different minimally invasive necrosectomy techniques with each other. This presents a problem for surgeons dealing with patients with pancreatic necrosis as they need to consult the available evidence to guide the selection of their treatment. This case provides a concise but general description of a minimally invasive approach to a pancreatic pseudocyst in a man with a history of alcoholic pancreatitis, with special reference to the surgical technique, the postoperative result and, above all, to point out the benefits of this type of approach.
VL  - 10
IS  - 5
ER  -

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