Video-assisted retroperitoneal necrosectomy on acute pancreatitis. Itauguá National Hospital, period 2015-2021

Abstract

INTRODUCTION: Acute pancreatitis on its necrotic form presents an estimated mortality of 50% in cases with surgery and up to 100% without surgery. MATERIALS: Observational, descriptive, retrospective, transversal study of patients with a complicated acute pancreatitis diagnosis who had a video-assisted necrosectomy performed through retroperitoneal approach on the Itauguá National Hospital, years 2015 to 2021. RESULTS: 35 patients with an average age of 57 years old, 60% were women, 57.1% were admitted with a severe pancreatitis diagnosis, and 42.9% with moderated pancreatitis. The percutaneous drainage was placed first in 29 cases, the patients were directly intervened with a video-assisted necrosectomy in 6 cases. The time between performing the draining and the debridement was 65.5% between the first and third subsequent week. Two thirds of the patients needed an additional surgical procedure, such as a second video-assisted debridement, cholecystectomy or open necrosectomy. A mortality of 11.4% was observed. CONCLUSION: Necrotizing pancreatitis’ treatment has now averted from open surgical debridement to a more conservative treatment and minimally invasive approaches. The video-assisted retroperitoneal debridement yielded relatively good results as a previous step to open surgery, hence avoiding complications befitting of a laparotomy.