Risse Olivier, Auguste Thomas, Delannoy Pierre, Cardin Nicolas, Bricault Ivan, Létoublon Christian
Département de Chirurgie Digestive et de l'Urgence, Hôpital Michallon, BP 217, 38043 Grenoble Cedex 9.
Gastroenterol Clin Biol. 2004 Oct;28(10 Pt 1):868-71. doi: 10.1016/s0399-8320(04)95150-0.
Percutaneous drainage of infected pancreatic necrosis is not always efficient and morbidity is high with open necrosectomy techniques. Minimally-invasive procedures have been developed to reduce this morbidity. We report our early experience with percutaneous video-assisted necrosectomy.
Among 61 patients with acute pancreatitis treated between January 2001 and February 2003, seven developed infected pancreatic necrosis. Six of these seven patients underwent percutaneous video-assisted necrosectomy after failure of radio-guided percutaneous drainage.
One to four sessions of percutaneous video-assisted necrosectomy were required. There was no death. Sepsis control was achieved in all patients. One patient developed postoperative peritonitis due to intraoperative contamination of the peritoneal cavity. Eighteen months after the last necrosectomy, one patient developed a pseudocyst which was successfully cured by percutaneous drainage. One patient developed diabetes mellitus.
Early experience in six patients has shown that percutaneous video-assisted necrosectomy is feasible, safe and efficient, in accordance with reports in the literature. Further evaluation is necessary.
经皮引流感染性胰腺坏死并非总是有效，开放性坏死组织清除术的发病率较高。已开发出微创手术以降低这种发病率。我们报告经皮视频辅助坏死组织清除术的早期经验。
在2001年1月至2003年2月间接受治疗的61例急性胰腺炎患者中，7例发生了感染性胰腺坏死。这7例患者中有6例在放射性引导下经皮引流失败后接受了经皮视频辅助坏死组织清除术。
需要进行1至4次经皮视频辅助坏死组织清除术。无死亡病例。所有患者的脓毒症均得到控制。1例患者因术中腹腔污染发生术后腹膜炎。最后一次坏死组织清除术后18个月，1例患者出现假性囊肿，经皮引流成功治愈。1例患者患糖尿病。
6例患者的早期经验表明，经皮视频辅助坏死组织清除术是可行、安全且有效的，与文献报道一致。有必要进行进一步评估。
