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首页> 外文期刊>BMC Gastroenterology >Double-catheter lavage combined with percutaneous flexible endoscopic debridement for infected pancreatic necrosis failed to percutaneous catheter drainage
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Double-catheter lavage combined with percutaneous flexible endoscopic debridement for infected pancreatic necrosis failed to percutaneous catheter drainage

机译:双导管灌洗结合经皮柔性内窥镜清创,用于感染的胰腺坏死未经经皮导管排水

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摘要

Infected pancreatic necrosis (IPN) is a serious local complication of acute pancreatitis, with high mortality. Minimally invasive therapy including percutaneous catheter drainage (PCD) has become the preferred method for IPN instead of traditional open necrosectomy. However, the efficacy of double-catheter lavage in combination with percutaneous flexible endoscopic debridement after PCD failure is unknown compared with surgical necrosectomy. A total of 27 cases of IPN patients with failure PCD between Jan 2014 and Dec 2015 were enrolled in this retrospective cohort study. Fifteen patients received double-catheter lavage in combination with percutaneous flexible endoscopic debridement, and 12 patients underwent open necrosectomy. The primary endpoint was the composite end point of major complications or death. The secondary endpoint included mortality, major complication rate, ICU admission length of stay, and overall length of stay. The primary endpoint occurrence rate in double-catheter lavage in combination with percutaneous flexible endoscopic debridement group (8/15, 53%) was significantly lower than that in open necrosectomy group (11/12, 92%) (RR?=?1.71, 95% CI?=?1.04 – 2.84, P?
机译:感染的胰腺坏死(IPN)是急性胰腺炎的严重局部并发症,具有高死亡率。在包括经皮导管引流(PCD)的微创疗法已成为IPN而不是传统开放的墓穴切除术的优选方法。然而,与外科墓切除术相比,双导管灌洗与经皮柔性内窥镜清创的疗效与经皮柔性内窥镜清创。 2014年1月至2015年1月至2015年12月之间共有27例IPN患者,参加了这项回顾性队列研究。十五名患者接受双导管灌洗与经皮柔性内窥镜清创,12名患者接受了突出的悲炭切除术。主要终点是主要并发症或死亡的复合终点。次要终点包括死亡率,重症并发症率,ICU入学率,以及总体逗留时间。双导管灌洗中的主要终点发生率与经皮柔性内窥镜清新组(8/15,53%)的组合显着低于开放的墓穴组(11/12,92%)(RR?= 1.71, 95%ci?=?1.04 - 2.84,p?<?0.05)。虽然两组之间的死亡率显示没有统计学意义(0%对17%,P?= 0.19),但在实验组中的新出现多器官衰竭和ICU入学时间的速度明显低于开放的坏死切除术(13%vs. 58%,p?= 0.04; 0与17,P?= 0.02)。只有40%的患者在经皮清创术后需要ICU入院,这明显低于接受手术的患者(83%; P?<0.05)。双导管灌洗与经皮柔性内窥镜清创患者相比,PCD失效后,患者患有卓越的有效性,安全性和便利性,与开放的坏死切除术后。

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