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首页> 外文期刊>Surgical Endoscopy >Management of infected pancreatic necrosis using retroperitoneal necrosectomy with flexible endoscope: 10 years of experience
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Management of infected pancreatic necrosis using retroperitoneal necrosectomy with flexible endoscope: 10 years of experience

机译：使用柔性内窥镜通过腹膜后坏死切除术治疗感染的胰腺坏死：10年的经验

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Background: This study was designed to provide our experience in the management of infected and drained pancreatic necrosis using the retroperitoneal approach. Methods: This was a prospective observational study in a tertiary care university hospital. Thirty-two patients with confirmed infected pancreatic necrosis were studied. Superficial necrosectomy was performed with lavage and aspiration of debris. This was achieved though a retroperitoneal approach of the pancreatic area and under the direct vision of a flexible endoscope. The follow-up procedure using retroperitoneal endoscopy did not require taking the patient to the operating room. The main outcome measures were infection control, morbidity, and mortality related to technique, reintervention, and long-term follow-up. Results: No significant morbidity or mortality related to the technique was observed in all of the patients with infected pancreatic necrosis treated with this retroperitoneal approach compared with published data using other approaches. Reinterventions were not required and patients are currently asymptomatic. Conclusions: Retroperitoneal access of the pancreatic area is a good approach for drainage and debridement of infected pancreatic necrosis. Translumbar retroperitoneal endoscopy allows exploration under direct visual guidance avoiding open transabdominal reintervention and the risk of contamination of the abdominal cavity. This technique does not increase morbidity and mortality, can be performed at the patients' bedside as many times as necessary, and has advantages over other retroperitoneal approaches.
机译：背景：本研究旨在为我们提供使用腹膜后方法处理感染和引流性胰腺坏死的经验。方法：这是一家三级护理大学医院的前瞻性观察研究。研究了32例确诊为感染性胰腺坏死的患者。进行浅表坏死切除，并进行灌洗和碎屑抽吸。这是通过胰腺区域的腹膜后入路并在柔性内窥镜的直接观察下实现的。使用腹膜后内窥镜检查的后续程序不需要将患者带到手术室。主要结果指标是与技术，再次干预和长期随访有关的感染控制，发病率和死亡率。结果：与使用其他方法发表的数据相比，在使用这种腹膜后方法治疗的所有感染性胰腺坏死患者中均未观察到与该技术相关的明显发病率或死亡率。不需要再次干预，患者目前无症状。结论：胰腺腹膜后入路是引流和清创感染性胰腺坏死的好方法。经腰腹腹膜后内窥镜检查可在直接的视觉指导下进行探查，避免开放性经腹再介入和避免腹腔污染的风险。该技术不会增加发病率和死亡率，可以在患者的床边进行多次，并且比其他腹膜后方法具有优势。

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