Department of Gastroenterology, Changhai Hospital, Shanghai, China.
Dig Endosc. 2012 Sep;24(5):299-308. doi: 10.1111/j.1443-1661.2012.01298.x. Epub 2012 Apr 8.
The aim of this study is to introduce recent progress in the treatment of pancreatic pseudocyst, abscess and necrosis using the endoscopic approach.
Studies on PubMed and MEDLINE from the last 30 years on progress in the management of the complications from severe pancreatitis were researched and reviewed. Herein, the indication for intervention, definition of fluid collection associated with acute pancreatitis and treatment modalities of these complications are summarized.
Three types of management are employed for complications of severe pancreatitis: the endoscopic, surgical and percutaneous approaches.
Over the years, as technical expertise has increased and instruments for endoscopy have improved, patients who had endoscopic surgery to address the complications of severe pancreatitis have had higher survival rates, lower mortality rates and lower complication rates than those having open debridement. However, traditional open abdominal surgery should be advocated when minimally invasive management fails or necrosis is extensive and extends diffusely to areas such as the paracolic gutter and the groin (i.e. locations not accessible by endoscopy).
本研究旨在介绍内镜治疗胰腺假性囊肿、脓肿和坏死的最新进展。
检索过去 30 年来在 PubMed 和 MEDLINE 上发表的关于重症胰腺炎并发症治疗进展的研究，并进行综述。在此，总结了介入的适应证、急性胰腺炎相关液体积聚的定义以及这些并发症的治疗方式。
重症胰腺炎的并发症采用三种方式进行治疗：内镜、外科和经皮途径。
多年来，随着技术专业知识的提高和内镜器械的改进，接受内镜手术治疗重症胰腺炎并发症的患者的生存率更高，死亡率和并发症发生率更低，而非手术清创术。然而，当微创管理失败或坏死广泛且广泛扩散至结肠旁沟和腹股沟等部位（即无法通过内镜到达的部位）时，应提倡传统的开放性腹部手术。
