PREPRINT
jkl keys enabled
32 views

Pancreatic Debridement via Sinus Tract Endoscopy

Peter Fagenholz, MD
Massachusetts General Hospital

1. Introduction

2. Surgical Approach

  1. Patient Positioning
  2. Patient Preparation

3. Exchanging Superior Drain for 30 French Sheath

  1. Adjust Incision
  2. Set Up and Align Fluoroscopy
  3. Dilate Drain Tract to 30 French
  4. Insert Super Stiff Amplatz Guidewire
  5. Remove Drain while Maintaining Guidewire Access
  6. Insert Balloon over Guidewire and Inflate
  7. Advance 30 French Sheath over Balloon
  8. Deflate and Remove Balloon
  9. Confirm Placement in Necrotic Cavity and Remove Guidewire

4. Debridement of Necrotic Pancreatic Tissue

5. Removing Sheath and Replacing Drain

6. Suture Drain

7. Drain Study to Examine Fistula

8. Exchanging Inferior Drain for 30 French Sheath

9. Examination of Cavity for Necrotic Tissue

10. Removing Sheath and Replacing Drain

11. Drain Study

12. Suture Drain

13. Post-op Remarks