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首页> 外文期刊>Surgical Endoscopy >Multimedia article. Laparoscopic infracolic necrosectomy for infected pancreatic necrosis.
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Multimedia article. Laparoscopic infracolic necrosectomy for infected pancreatic necrosis.

机译：多媒体文章。腹腔镜下结肠坏死切除术治疗感染性胰腺坏死。

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Infected pancreatic necrosis carries a high morbidity and mortality from sepsis and multisystem organ failure. Following confirmation of the infection by CT-guided fine needle aspiration, treatment consists of broad spectrum antibiotics (imipenim-cilastin) followed by emergency open (laparotomy) digital necrosectomy and insertion of drains for postoperative lavage with hyperosmolar dialysate as advocated by Beger et al. This video shows an alternative laparoscopic technique to open necrosectomy and has been used in Dundee since 1994. After elevation of the transverse colon, the lesser sac is opened through the root of the transverse colon between the middle and left colic vessels. The necrosectomy is accomplished from inside the lesser sac under vision with a combination of pulsed irrigation and graspers. On completion of the necrosectomy, two large drains are inserted into the lesser sac for postoperative irrigation. The experience with this technique has been favorable with a patient survival of 85%.
机译：感染的胰腺坏死因败血症和多系统器官衰竭而具有很高的发病率和死亡率。通过CT引导的细针穿刺抽吸确认感染后，治疗由广谱抗生素（imipenim-cilastin）组成，随后进行紧急开放式（laparotomy）数字坏死切除术，并按Beger等人的建议在术后用高渗透析液冲洗引流管。该视频显示了一种可替代的腹腔镜技术，用于行坏死性结肠切除术，自1994年以来已在Dundee使用。横结肠结肠抬高后，小囊通过中结肠和左绞肠血管之间的横结肠根部打开。坏死切除术是通过脉冲冲洗和抓紧器的结合，从视力较小的囊内部完成的。坏死切除术完成后，将两个大的引流管插入小囊以进行术后冲洗。使用该技术的经验对于患者生存率高达85％十分有利。

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