van Santvoort H C, Besselink M G H, Cirkel G A, Gooszen H G
Universitair Medisch Centrum Utrecht, afd. Heelkunde, G04.228, Postbus 85.500, 3508 GA Utrecht.
Ned Tijdschr Geneeskd. 2006 Aug 19;150(33):1844-6.
Surgical intervention in infected necrotising pancreatitis generally consists of necrosectomy via laparotomy. The morbidity and mortality after this procedure might be reduced by minimally invasive strategies. The 20 hospitals of the Dutch Acute Pancreatitis Study Group are currently enrolling patients in a randomised trial to compare (a) laparotomy with necrosectomy and continuous postoperative lavage with (b) CT-guided or endoscopic transgastric drainage, if necessary, followed by videoscopic assisted retroperitoneal debridement (VARD): the PANTER trial ('pancreatitis, necrosectomy versus a minimally invasive step-up approach'). The primary endpoint is the proportion of patients suffering from major postoperative morbidity and mortality. Patients with (suspected) infected necrotising pancreatitis can be put forward for participation in the trial in one of the 20 participating centres.
感染性坏死性胰腺炎的外科干预通常包括通过剖腹手术进行坏死组织清除术。这种手术的发病率和死亡率可能会通过微创策略降低。荷兰急性胰腺炎研究组的20家医院目前正在招募患者参加一项随机试验,以比较:(a) 剖腹手术加坏死组织清除术及术后持续灌洗与 (b) 必要时采用CT引导或内镜经胃引流,随后进行视频辅助腹膜后清创术(VARD):即PANTER试验(“胰腺炎,坏死组织清除术与微创逐步治疗法”)。主要终点是术后发生严重并发症和死亡的患者比例。患有(疑似)感染性坏死性胰腺炎的患者可在20个参与中心之一被推荐参加该试验。