Whitehead Diana A, Gardner Timothy B
Section of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH, 03756, USA,
Curr Treat Options Gastroenterol. 2014 Sep;12(3):322-32. doi: 10.1007/s11938-014-0018-7.
Pancreatic necrosis may result as a complication of acute pancreatitis, often causing significant morbidity and mortality. There are many recommendations concerning the management of pancreatic necrosis, including non-operative management with supportive care and antibiotics, computed tomography (CT)-guided percutaneous drainage, endoscopic transluminal drainage, and operative necrosectomy. Historically, pancreatic necrosis has been treated surgically. However, surgical management of pancreatic necrosis is associated with high mortality (6-28 %) and morbidity (19-62 %). Thus, endoscopic therapy has emerged as a relatively new minimally invasive technique for treating infected and/or symptomatic pancreatic necrosis in the last decade. Although there have been two randomized trials comparing endoscopic transluminal drainage versus operative necrosectomy, there is little data regarding timing, indication, and outcomes of these procedures.
胰腺坏死可能是急性胰腺炎的一种并发症，常导致显著的发病率和死亡率。关于胰腺坏死的处理有许多建议，包括采用支持治疗和抗生素的非手术治疗、计算机断层扫描（CT）引导下经皮引流、内镜腔内引流以及手术清创术。从历史上看，胰腺坏死一直通过手术治疗。然而，胰腺坏死的手术治疗伴随着高死亡率（6%-28%）和高发病率（19%-62%）。因此，在过去十年中，内镜治疗已成为一种相对较新的微创技术，用于治疗感染性和/或有症状的胰腺坏死。尽管已有两项随机试验比较内镜腔内引流与手术清创术，但关于这些手术的时机、适应症和结果的数据很少。
