Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
Clin Gastroenterol Hepatol. 2012 Nov;10(11):1202-7. doi: 10.1016/j.cgh.2012.07.009. Epub 2012 Jul 24.
It has been nearly 20 years since the first peroral endoscopic necrosectomy was performed for patients with pancreatitis. We have since increased our understanding of pancreatitis, and the nomenclature has changed to define disease in which necrosis becomes organized (called "walled-off"). Endoscopic approaches to evaluate and treat pancreatitis have progressed from making small transmural tracts for irrigation to making large tracts, which allow the endoscope to move directly into necrotic cavities and perform endoscopic necrosectomy. The purpose of endoscopic debridement is to irrigate and/or remove areas of necrosis. Collaboration between therapeutic endoscopists and interventional radiologists has led to a combined approach to organized pancreatic necrosis. We discuss the history of peroral endoscopic treatment of organized (walled-off) pancreatic necrosis and current endoscopic approaches to therapy.
自首例内镜下经口胰腺坏死组织清除术应用于胰腺炎患者以来，已经过去了近 20 年。在此期间，我们对胰腺炎的认识不断加深，命名也发生了变化，将坏死组织发生机化的疾病定义为“包裹性坏死”。内镜下评估和治疗胰腺炎的方法也从经小的壁间通道进行灌洗发展到大口径通道，允许内镜直接进入坏死腔并进行内镜下坏死组织清除术。内镜清创的目的是冲洗和/或清除坏死区域。治疗性内镜医师与介入放射科医师之间的合作促成了一种针对包裹性胰腺坏死的联合治疗方法。我们讨论了经口内镜治疗包裹性（有壁）胰腺坏死的历史以及当前的内镜治疗方法。
