中国实用外科杂志2018，Vol.38Issue(1)：97-100,4.DOI:10.19538/j.cjps.issn1005-2208.2018.01.22
腹腔镜辅助经网膜囊胰腺坏死组织清除治疗感染性胰腺坏死疗效分析
Single step laparoscopic assisted trans-lesser sac debridement in treatment of peripancreatic infected pancreatic necrosis
摘要
Abstract
Objective To explore the safety and effectiveness of single step laparoscopic assisted trans-lesser sac debridement(LATLSD) in treatment of peripancreatic infected pancreatic necrosis.Methods 35 patients with infected pancreatic necrosis,who received single step LATLSD were included in this study and analyzed retrospectively.All cases of necrotic tissue and infected fluid were concentrated in the peripancreatic region.Technical success rate,treatment success rate,morbidity and mortality were recorded as main outcome.The secondly outcome including initial operation time,estimated blood loss,the vital sign and infection marker on postoperative 24 hour and lweek was also analyzed.Results All cases were underwent operation successfully.Operation time,estimated blood loss during the first operation was (78.9±25.3) min and 20(10～ 600)ml.(3.8± 1.0) drains were placed in the initial procedure.The mean times of operation and hospital stay were (2.3 ± 1.6) times and (44.8± 32.2) days,respectively.Bacterial culture was positive in 34(97.1％) patients.The overall complication rate was 17.1％(6/35),including new onset of organ dysfunction in 4 cases (1 case of simultaneous abdominal bleeding),gastric leak in 1 case,colonic leakage in 1 case.Clavien-Dindo grade Ⅲ or severer complications occurred in 5 cases (14.3％).The mortality was 5.7％(2/35) and the treatment success rate was 94.3％.The white blood cell count was decreased significantly on postoperative 24 hour[(10.6±6.6)× 109/L vs.(12.6±6.3)× 109/L,P＜0.01],and the vital signs and infection markers significantly improved on postoperative 1 week.Conclusion Single step LATLSD was safe and effective in treatment of peripancreatic infected pancreatic necrosis.关键词
胰腺炎/感染性胰腺坏死/腹腔镜/网膜囊Key words
pancreatitis/infected pancreatic necrosis/laparoscopy/lesser sac分类
医药卫生引用本文复制引用
曹锋,李昂,刘殿刚,段宁,高崇崇,武玉多,丁乙轩,王喆,李非..腹腔镜辅助经网膜囊胰腺坏死组织清除治疗感染性胰腺坏死疗效分析[J].中国实用外科杂志,2018,38(1):97-100,4.基金项目
北京市科学技术委员会首都临床特色应用研究与成果推广项目(No.Z171100001017077) （No.Z171100001017077）
北京市医院管理局临床医学发展专项(No.XMLX201404) （No.XMLX201404）
