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Pancreas
PMO-100 Outcome of minimally invasive pancreatic necrosectomy without irrigation
  1. D J Malde,
  2. S S Raza,
  3. N Khan,
  4. A Aldouri,
  5. K Menon,
  6. A M Smith
  1. The HPB Unit, St James University Hospital, Leeds, UK

Abstract

Introduction Necrotizing Pancreatitis with secondary infection of the pancreatic tissue is associated with significant morbidity and mortality. Current evidence suggests that a minimally invasive retroperitoneal necrosectomy (MIRP) is feasible, well tolerated and beneficial for the patient when compared with open surgery.

Methods A total of 16 patients who underwent MIRP from September 2007 to April 2011 were included in the study. Current minimal access techniques all recommend routine irrigation but we aim to show that comparable results can be achieved without irrigation.

Results The mean age was 52.5 years with 13 patients transferred from other centres. The aetiology was gallstones (13), alcohol (1), idiopathic (1) and hyperlipidaemia (1). The average time before 1st necrosectomy was 50.2 days. The mean number of procedures was 3.3 (range 1–7) with one patient requiring an open procedure. One patient required post-necrosectomy ICU admission. 13 patients had nasojejunal feed and four patients started with parenteral feed which was later converted to nasojejunal. Five patients developed a pancreatic fistula, three patients developed colonic fistula and two patients died. Mean inpatient stay was 82.6 days (range 31–182).

Conclusion This series suggests that doing MIRP without irrigation has results comparable to other centres carrying out routine irrigation.

Competing interests None declared.

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