Lozev I, Kirov G, Dardanov D, Smilov N, Moshev B, Gaidarski R
Khirurgiia (Sofiia). 2010(2-3):24-7.
The study aims to evaluate the efficacy of percutaneous necrosectomy performed under ultrasound control and endoscopic necrosectomy trough secondary sinus track (ENTSST) using nephroscope and cystoscope.
Puncture of fluid collections in the pancreas was performed under ultrasonographic control to 23 patients with acute necrotizing pancreatitis (ANP). ENTSST using nephroscope and cystoscope was performed to 47 patients after open or percutaneous necrosectomy and persistent sepsis (without satellite collection of CT).
Seventeen (74%) patients treated with percutaneous necrosectomy recovered without open surgery. Two of this group died. The average hospital stay was 42 days. Twenty-three patients required an average of two (from 1 to 4) ENTSST.
Based on our initial results we believe that the percutaneous necrosectomy and ENTSST in well selected patients might be the better choice than the open necrosectomy and postoperative lavage. Common solution of these methods has not been reached yet.
本研究旨在评估在超声引导下进行经皮坏死组织清除术以及使用肾镜和膀胱镜经继发窦道进行内镜坏死组织清除术（ENTSST）的疗效。
对23例急性坏死性胰腺炎（ANP）患者在超声引导下进行胰腺液体积聚穿刺。对47例在开放或经皮坏死组织清除术后仍持续发生脓毒症（CT检查无卫星灶）的患者，使用肾镜和膀胱镜进行ENTSST。
17例（74%）接受经皮坏死组织清除术的患者未行开放手术即康复。该组中有2例死亡。平均住院时间为42天。23例患者平均需要进行两次（1至4次）ENTSST。
基于我们的初步结果，我们认为对于精心挑选的患者，经皮坏死组织清除术和ENTSST可能比开放坏死组织清除术和术后灌洗是更好的选择。尚未找到这些方法的通用解决方案。
