Ren Ying-Chun, Chen Su-Min, Cai Xiao-Bo, Li Bai-Wen, Wan Xin-Jian
Department of Gastroenterology, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, China.
Department of Gastroenterology, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, China.
Dig Liver Dis. 2017 Jan;49(1):38-44. doi: 10.1016/j.dld.2016.08.120. Epub 2016 Sep 1.
Endoscopic ultrasonography-guided drainage has been established as a good treatment modality in the management of walled-off pancreatic necrosis, but the unmanageable infection of postoperation is still a thorny problem due to the poor drainage ability for solid necrotic debris only through transmural stent and nasocystic catheter.
Introduce a novel therapeutic method, namely endoscopic ultrasonography-guided drainage combined with cyclic irrigation technique in managing patients with walled-off pancreatic necrosis.
18 patients with severe acute pancreatitis complicated with walled-off pancreatic necrosis received treatment with endoscopic ultrasonography-guided drainage combined with cyclic irrigation were involved in this retrospective study.
17 of 18 patients with walled-off pancreatic necrosis were treated by this new therapeutic method. Subsequent surgery was performed in 1 case due to uncontrolled infection, complications such as perforation, bleeding or multiple organ failure were not observed. Treatment success rate was high (16 in 17, 94.12%).
Endoscopic ultrasonography-guided drainage combined with cyclic irrigation is an effective treatment option for symptomatic walled-off pancreatic necrosis to facilitate drainage and obviate the need for subsequent surgery or endoscopic necrosectomy.
内镜超声引导下引流已被确立为治疗包裹性胰腺坏死的一种良好治疗方式，但由于仅通过经壁支架和鼻囊肿导管对实性坏死碎片的引流能力较差，术后难以控制的感染仍然是一个棘手的问题。
介绍一种新的治疗方法，即内镜超声引导下引流联合循环冲洗技术治疗包裹性胰腺坏死患者。
本回顾性研究纳入了18例重症急性胰腺炎合并包裹性胰腺坏死且接受内镜超声引导下引流联合循环冲洗治疗的患者。
18例包裹性胰腺坏死患者中有17例采用了这种新的治疗方法。1例因感染控制不佳而进行了后续手术，未观察到穿孔、出血或多器官功能衰竭等并发症。治疗成功率较高（17例中的16例，94.12%）。
内镜超声引导下引流联合循环冲洗是治疗有症状的包裹性胰腺坏死的一种有效治疗选择，有助于引流并避免后续手术或内镜坏死组织清除术的需要。
