Zhu J F, Fan X H, Zhang X H
Department of General Surgery, Jinan General Hospital, 25 Shi Fan Road, Jinan, 250031, People's Republic of China.
Surg Endosc. 2001 Feb;15(2):146-8. doi: 10.1007/s004640000349.
The appropriate surgical treatment for severe acute pancreatitis has been disputed for a long time. Herein we describe our experience with the laparoscopic treatment of this disease.
Ten patients, seven male and three female, with an average age of 55 years were diagnosed with severe acute pancreatitis. All cases but one were found to be without biliary stones by ultrasonic and CT scans. Laparoscopic exploration, irrigation, drainage, and decompression of the pancreas were performed. Further treatment, including gastric decompression, irrigation via the drainage tubes, antibiotics, somatostatin, and parenteral nutrition, was continued in all patients following the laparoscopic procedures.
Nine patients recovered successfully; one died from adult respiratory distress syndrome (ARDS) soon after the operation. The hospital stay was 10-30 days.
The laparoscopic era offers new hope for the treatment of severe acute pancreatitis. The technique can be used to determine the pathologic extent of the disease, to irrigate and drain the abdominal cavity, and to decompress the pancreas. Almost every surgical procedure for acute pancreatitis can be performed laparoscopically.
对于重症急性胰腺炎的恰当外科治疗长期以来存在争议。在此我们描述我们对这种疾病进行腹腔镜治疗的经验。
10例患者,7例男性,3例女性,平均年龄55岁,被诊断为重症急性胰腺炎。除1例患者外,所有病例经超声和CT扫描均未发现胆结石。进行了腹腔镜探查、胰腺冲洗、引流及减压。腹腔镜手术后,所有患者继续接受进一步治疗,包括胃肠减压、经引流管冲洗、抗生素、生长抑素及肠外营养。
9例患者成功康复;1例患者术后不久死于成人呼吸窘迫综合征(ARDS)。住院时间为10至30天。
腹腔镜时代为重症急性胰腺炎的治疗带来了新希望。该技术可用于确定疾病的病理范围、冲洗和引流腹腔以及为胰腺减压。几乎所有急性胰腺炎的外科手术都可通过腹腔镜进行。