Endoscopic necrosectomy is a specialized endoscopic procedure used to remove necrotic tissue or debris from the pancreas or other areas of the gastrointestinal tract affected by necrosis. At SHIFAA PAN African Hospitals, our Gastroenterology Department employs advanced techniques like endoscopic necrosectomy to manage severe cases of pancreatic necrosis and related complications.

Symptoms:

Patients with pancreatic necrosis may experience symptoms such as severe abdominal pain, fever, nausea, vomiting, and potentially signs of systemic inflammation or organ failure. Endoscopic necrosectomy may be indicated when conservative management fails to alleviate symptoms or when complications arise.

Investigation and Diagnosis:

Diagnosis of pancreatic necrosis involves a combination of clinical evaluation, imaging studies such as abdominal CT scans or MRI, and laboratory tests to assess pancreatic enzymes and markers of inflammation. Endoscopic retrograde cholangiopancreatography (ERCP) may also be performed to visualize the pancreatic ducts and assess the extent of necrosis.

Preparation:

Before undergoing endoscopic necrosectomy, patients are typically advised to fast for a certain period to ensure the stomach is empty. Depending on the individual case, additional preparation may include discontinuing certain medications or adjusting treatment regimens.

Procedure:

Endoscopic necrosectomy is performed under sedation or general anesthesia. During the procedure, an endoscope is advanced through the mouth or nose into the gastrointestinal tract, allowing access to the site of necrosis. Specialized tools, such as graspers, snares, or baskets, are used to remove necrotic tissue or debris under direct visualization.

Post-Procedure Care:

After endoscopic necrosectomy, patients are monitored closely in a recovery area until the effects of sedation or anesthesia wear off. They may experience mild discomfort or soreness, which can typically be managed with pain medications. Patients are advised to follow specific post-procedure instructions, including dietary restrictions, medication management, and activity guidelines.

Recovery Time:

Recovery time following endoscopic necrosectomy varies depending on the extent of the necrosis, the patient’s overall health, and any complications that may arise. Patients may need to undergo multiple procedures over time to achieve optimal outcomes.

 

What is endoscopic necrosectomy?

Endoscopic necrosectomy is a specialized endoscopic procedure used to remove necrotic tissue or debris from the pancreas or other areas of the gastrointestinal tract affected by necrosis.

 

When is endoscopic necrosectomy indicated?

Endoscopic necrosectomy may be indicated in patients with severe pancreatic necrosis or complications such as infected necrosis that do not respond to conservative management.

 

How is endoscopic necrosectomy performed?

Endoscopic necrosectomy is performed using an endoscope inserted through the mouth or nose into the gastrointestinal tract. Specialized tools are then used to remove necrotic tissue or debris under direct visualization.

 

What are the risks associated with endoscopic necrosectomy?

Risks include bleeding, perforation of the gastrointestinal tract, infection, and complications related to sedation or anesthesia. The risk is generally low but may vary depending on the specific case and patient’s health.

 

How effective is endoscopic necrosectomy in treating pancreatic necrosis?

Endoscopic necrosectomy can be highly effective in removing necrotic tissue and alleviating symptoms associated with pancreatic necrosis. Success depends on various factors, and multiple procedures may be required in some cases.

 

What are the benefits of endoscopic necrosectomy?

Benefits include a minimally invasive approach, targeted removal of necrotic tissue, and potential avoidance of more invasive surgical procedures. Endoscopic necrosectomy can help improve patient outcomes and quality of life in select cases of pancreatic necrosis.