肝胆胰外科杂志2025，Vol.37Issue(6)：381-385,5.DOI:10.11952/j.issn.1007-1954.2025.06.005
肾镜联合胆道镜经窦道治疗残余感染性胰腺坏死
Nephroscopy combined with choledochoscopy via sinus tract for treatment of residual infectious pancreatic necrosis
摘要
Abstract
Objective To investigate the safety and efficacy of nephroscopy combined with choledochoscopy via trans-drainage tube sinus tract for treatment of residual infectious pancreatic necrosis(IPN).Methods The clinical data of 36 patients,who admitted to Hunan Provincial People's Hospital between Jan.2020 and Jul.2023 and underwent nephroscopy combined with choledochoscopy for treatment of residual IPN,were retrospectively analyzed.Results Among the 36 IPN patients,there were 26 males and 10 females,with an average age of(43.5±8.8)years.The time for percutaneous drainage(PCD)and double cannula drainage prior to endoscopy was(11.2±1.8)d and(9.1±2.3)d,respectively.Among the 36 IPN patients,94.4%(34/36)completed endoscopic treatment,the average number of endoscopic clearances was(2.5±1.2)times,and the average operation time was(51.9±21.4)min.The difference in preoperative and postoperative peripancreatic necrosis volume was(277.7±103.1)mL.Endoscopy-related complications occurred in 5 of 36 patients(13.9%),with 1 case of colonic fistula and 1 case of bleeding,that required conversion to laparotomy;1 case with transient dyspnea due to gas embolism and then underwent gas-free abdominal debridement;1 case with bleeding was treated with titanium clips after compression with hemostatic gauze;1 case with sinus tract rupture was scheduled for repeat endoscopic debridement.No death case was found in this study.The average hospitalization time was(33.7±10.5)d,and the median intubation time after discharge was 43 d.The proportion of patients requiring surgical intervention after endoscopy was 11.1%(4/36).Conclusion The combined use of nephroscope and choledochoscope via sinus tract can remove residual IPN safely and effectively,resulting in a shortened duration of hospitalization and postoperative intubation time.关键词
重症急性胰腺炎/感染性胰腺坏死/经皮内镜坏死组织清除术/胆道镜/肾镜Key words
severe acute pancreatitis/infective pancreatic necrosis/percutaneous endoscopic necrosectomy/nephroscopy/choledochoscopy分类
临床医学引用本文复制引用
李佳,刘子雄,李国光,隆艳飞,成伟,刘毅..肾镜联合胆道镜经窦道治疗残余感染性胰腺坏死[J].肝胆胰外科杂志,2025,37(6):381-385,5.基金项目
湖南省临床医疗技术创新引导项目(2020SK50912) （2020SK50912）
湖南省自然科学基金项目(2025JJ80749). （2025JJ80749）
