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ENDOSKOPISK TRANSMURAL DRENASJE OG NEKROSEKTOMI HOS PASIENTER MED AKUTT PANKREATITT

De senere år har endoskopisk transmural drenasje fått en stadig mer sentral plass i behandlingen av infiserte nekroser i forløpet av akutt pankreatitt og metoden er nå akseptert som førstelinjebehandling. Det er utviklet nye korte stenter, såkalt «lumen apposing» metallstent (LAMS), med stor diameter som gir god drenasje og muliggjør direkte endoskopisk nekrosektomi. Hos de fleste pasienter er endoskopisk behandling alene nok til at en «walled-off» nekrose (WON) går i regress. Sammenlignet med kirurgisk drenasje gir endoskopisk behandling færre komplikasjoner, kortere sykehusopphold og reduserte kostnader, og på lengre sikt også mindre behov for reintervensjoner.

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