Szentkereszty Zsolt, Csiszkó Adrienn
Debreceni Egyetem Orvos- és Egészségtudományi Centrum, Sebészeti Intézet, Debrecen.
Magy Seb. 2012 Feb;65(1):9-13. doi: 10.1556/MaSeb.65.2012.1.2.
The incidence of intraabdominal hypertension or abdominal compartment syndrome, as the more severe form is called, is relatively high in patients with severe acute pancreatitis, and therefore more attention is needed to the topic. If conservative treatment fails, immediate surgical decompression is indicated. The most commonly used operation is a full thickness median laparotomy, but a transversal laparotomy may also be effective. Although subcutaneous linea alba, or bilateral anterior rectus fasciotomy is safe and effective, decompressive laparotomy is indicated in failure of these methods. The open abdomen therapy is not advised due to high morbidity. Primary closure of the abdomen is preferable.
腹内高压或腹腔间隔室综合征(后者是更严重的形式)在重症急性胰腺炎患者中的发生率相对较高,因此该话题需要更多关注。如果保守治疗失败,则需立即进行手术减压。最常用的手术是全层正中剖腹术,但横向剖腹术也可能有效。虽然皮下白线或双侧腹直肌筋膜切开术安全有效,但这些方法失败时则需进行减压剖腹术。由于发病率高,不建议采用开放腹腔疗法。最好进行一期腹壁关闭。