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Your search keyword '"Stephanie Reichel"' showing total 4 results
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4 results on '"Stephanie Reichel"'

1. Open Surgical versus Minimal Invasive Necrosectomy of the Pancreas-A Retrospective Multicenter Analysis of the German Pancreatitis Study Group.

Author

Sebastian Rasch, Veit Phillip, Stephanie Reichel, Bettina Rau, Christian Zapf, Jonas Rosendahl, Ulrich Halm, Markus Zachäus, Martin Müller, Alexander Kleger, Albrecht Neesse, Jochen Hampe, Mark Ellrichmann, Felix Rückert, Peter Strauß, Alexander Arlt, Volker Ellenrieder, Thomas M Gress, Werner Hartwig, Ernst Klar, Joachim Mössner, Stefan Post, Roland M Schmid, Thomas Seufferlein, Marco Siech, Jens Werner, Uwe Will, and Hana Algül

Subjects
Medicine, Science
Abstract

Necrotising pancreatitis, and particularly infected necrosis, are still associated with high morbidity and mortality. Since 2011, a step-up approach with lower morbidity rates compared to initial open necrosectomy has been established. However, mortality and complication rates of this complex treatment are hardly studied thereafter.The German Pancreatitis Study Group performed a multicenter, retrospective study including 220 patients with necrotising pancreatitis requiring intervention, treated at 10 hospitals in Germany between January 2008 and June 2014. Data were analysed for the primary endpoints "severe complications" and "mortality" as well as secondary endpoints including "length of hospital stay", "follow up", and predisposing or prognostic factors.Of all patients 13.6% were treated primarily with surgery and 86.4% underwent a step-up approach. More men (71.8%) required intervention for necrotising pancreatitis. The most frequent etiology was biliary (41.4%) followed by alcohol (29.1%). Compared to open necrosectomy, the step-up approach was associated with a lower number of severe complications (primary composite endpoint including sepsis, persistent multiorgan dysfunction syndrome (MODS) and erosion bleeding: 44.7% vs. 73.3%), lower mortality (10.5% vs. 33.3%) and lower rates of diabetes mellitus type 3c (4.7% vs. 33.3%). Low hematocrit and low blood urea nitrogen at admission as well as a history of acute pancreatitis were prognostic for less complications in necrotising pancreatitis. A combination of drainage with endoscopic necrosectomy resulted in the lowest rate of severe complications.A step-up approach starting with minimal invasive drainage techniques and endoscopic necrosectomy results in a significant reduction of morbidity and mortality in necrotising pancreatitis compared to a primarily surgical intervention.

Published
2016
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2. Flexible percutaneous endoscopic retroperitoneal necrosectomy as rescue therapy for pancreatic necroses beyond the reach of endoscopic ultrasonography: A case series

Author

Christian Jürgensen, Jochen Hampe, Frank Neser, Sven Pannach, Stephanie Reichel, Marius Distler, Uwe Will, Jürgen Weitz, Stefan Brückner, and M. Kilian

Subjects
medicine.medical_specialty, Percutaneous, Abdominal compartment syndrome, business.industry, Gastroenterology, Endoscopic ultrasonography, Splenic artery, medicine.disease, Surgery, 03 medical and health sciences, 0302 clinical medicine, Rescue therapy, 030220 oncology & carcinogenesis, medicine.artery, Medicine, Pancreatitis, 030211 gastroenterology & hepatology, Radiology, Nuclear Medicine and imaging, In patient, Major complication, Radiology, business
Abstract

Minimally invasive or endoscopic transluminal drainage and necrosectomy are the standard of care for infected pancreatic fluid collections and necroses after pancreatitis. In an endoscopic treatment algorithm, necroses beyond the reach of safe endoscopic access are typically treated by percutaneous drainage. We aimed to evaluate percutaneous minimally invasive necrosectomy using a purely endoscopic technique in patients with extensive necrosis. In patients with necroses beyond safe transluminal reach, the percutaneous drainage canal was used for flexible endoscopic access and dilatation of the tract to 20 mm. Percutaneous endoscopic necrosectomy was carried out through this canal. We present a case series of 14 patients in whom between one and four necrosectomy (median two) sessions were done to remove solid necroses successfully in 13 out of 14 patients. There were no major complications apart from one patient with abdominal compartment syndrome secondary to delayed erosion of the splenic artery. Percutaneous flexible necrosectomy might evolve into an alternative to surgical minimally invasive necrosectomy in anatomical sites beyond transluminal endoscopic reach.

Published
2017
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3. Severe bleeding is a rare event in patients receiving lumen-apposing metal stents for the drainage of pancreatic fluid collections

Author

Katja Matthes, Uwe Will, Stephanie Reichel, Jochen Hampe, Mark Ellrichmann, Stefan Sulk, Alexander Arlt, Stefan Brueckner, Sebastian Zeissig, and Margarete Hohmann

Subjects
0301 basic medicine, Severe bleeding, medicine.medical_specialty, Gastrointestinal bleeding, Pancreatic pseudocyst, Lumen (anatomy), 03 medical and health sciences, 0302 clinical medicine, Pancreatic Fluid, Pancreatic Juice, medicine, Humans, In patient, High rate, business.industry, Gastroenterology, Pancreatic Diseases, medicine.disease, Surgery, 030104 developmental biology, Metals, Pancreatitis, Drainage, 030211 gastroenterology & hepatology, Stents, business
Abstract

Pancreatic fluid collections (PFCs) including pancreatic pseudocysts (PPCs) and walled-off necrosis (WON) frequently develop in the context of pancreatitis. Lumen-apposing self-expanding metal stents (LAMS) are increasingly used for the endoscopic management of infected and symptomatic PFCs since they facilitate direct endoscopic inspection and necrosectomy of WONs.1–3 However, two reports recently published in Gut 4 5 demonstrated high rates of haemorrhage associated with LAMS that were observed in up to 25% of patients and often occurred in a delayed manner with serious and fatal bleeding episodes reported. These data raised important concerns about the safety of LAMS and the optimal management of patients with infected or symptomatic PFCs. As a limitation, the reports by Bang et al 4 and Stecher et al 5 were based on relatively small group sizes of 12 and 46 LAMS-treated patients, respectively. To investigate whether the reported safety signals are similarly observed in …

Published
2018

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