中国实用外科杂志2016，Vol.36Issue(11)：1197-1199,3.DOI:10.7504/CJPS.ISSN1005-2208.2016.11.16
微创腹膜后入路胰腺坏死组织清除术治疗感染性胰腺坏死18例疗效分析
Role of minimal access retroperitoneal pancreatic necrosectomy in the treatment of infected pancreatic necrosis：An analysis of 18 cases
黄耿文 1申鼎成 1亢浩 1周书毅1
作者信息
- 1. 中南大学湘雅医院胰胆外科，湖南长沙410008
- 折叠
摘要
Abstract
Objective To summarize the role of minimal access retroperitoneal pancreatic necrosectomy (MARPN)in the treatment of infected pancreatic necrosis (IPN). Methods The clinical data of 18 cases of IPN performed MARPN in Xiangya Hospital,Central South University between September 2013 and July 2016 were analyzed retrospectively. All the cases included 15 cases treated with percutaneous catheter drainage plus MARPN and 3 cases with open drainage plus MARPN. Results The culture of peripancreatic drainage in all the 18 cases showed multiple microorganisms. The sepsis was completely reversed through MARPN in 15 cases(83.3%) and only 1 case converted to open surgical necrosectomy because of bleeding and intestinal leakage. The postoperative morbidity included 7 cases (38.9%) of pancreatic leakage,5 cases (27.8%) of intestinal leakage and 2 cases (11.1%) of bleeding. The overall mortality rate was 16.7%(3/18) and the underlying reasons for the mortality included bleeding and intestinal leakage,which led to multiple organ dysfunction syndrome. Conclusion Step-up or step-down approach based on MARPN is an effective strategy to treat infected pancreatic necrosis.关键词
重症胰腺炎/感染性胰腺坏死/微创腹膜后入路胰腺坏死组织清除术Key words
severe acute pancreatitis/infected pancreatic necrosis/minimal access retroperitoneal pancreatic necrosectomy分类
医药卫生引用本文复制引用
黄耿文,申鼎成,亢浩,周书毅..微创腹膜后入路胰腺坏死组织清除术治疗感染性胰腺坏死18例疗效分析[J].中国实用外科杂志,2016,36(11):1197-1199,3.
