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Hobart W. Harris, MD, MPH
San Francisco, Calif

Arch Surg. 2002;137:1063.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Castellanos and colleagues report their experience using a translumbar approach to treat infected pancreatic necrosis in 15 patients. The authors conclude that this approach, combined with continuous lavage, is safe, facilitates subsequent debridements, and is generally less morbid than a transperitoneal approach. In the last 2 patients presented, the authors added retroperitoneoscopy using a flexible endoscope to the treatment regimen. This addition purportedly facilitated control of the evolving peripancreatic necrosis.

The need for surgical intervention in patients with infected pancreatic necrosis is universally accepted. However, controversy exists regarding the timing of surgery and the recommended surgical procedure. There are no class 1 data (randomized controlled trials) to quiet the debate. Thus, clinicians, often with religious fervor, promote various surgical procedures and therapeutic regimens. In the final analysis, the goals of any intervention should include safe decompression of the infected collections, removal of necrotic debris, and . . . [Full Text of this Article]

RELATED ARTICLE

Infected Pancreatic Necrosis: Translumbar Approach and Management With Retroperitoneoscopy
Gregorio Castellanos, Antonio Piñero, Andrés Serrano, and Pascual Parrilla
Arch Surg. 2002;137(9):1060-1063.
ABSTRACT | FULL TEXT