Jagielski Mateusz, Smoczyński Marian, Adrych Krystian
Department of Gastroenterology and Hepatology, Medical University of Gdansk, Gdansk, Poland.
Wideochir Inne Tech Maloinwazyjne. 2017 Jun;12(2):199-205. doi: 10.5114/wiitm.2017.68298. Epub 2017 Jun 13.
The development of minimally invasive techniques allowed access to the necrotic cavity through transperitoneal, retroperitoneal, transmural and transpapillary routes. The choice of access to walled-off pancreatic necrosis (WOPN) should depend not only on the spread of necrosis, but also on the experience of the clinical center. Herein we describe treatment of a patient with multilocular symptomatic walled-off pancreatic necrosis using minimally invasive techniques. The single transmural access (single transluminal gateway technique - SGT) to the necrotic collection of the patient was ineffective. The second gastrocystostomy was performed using the same minimally invasive technique as an extra way of access to the necrosis (multiple transluminal gateway technique - MTGT). In the described case the performance of the new technique consisting in endoscopic multiplexing transmural access (MTGT) was effective enough and led to complete recovery of the patient.
微创技术的发展使得可以通过经腹膜、经后腹膜、经壁和经乳头途径进入坏死腔。进入包裹性胰腺坏死（WOPN）的途径选择不仅应取决于坏死的范围，还应取决于临床中心的经验。在此，我们描述了一位患有多房性有症状包裹性胰腺坏死的患者采用微创技术的治疗情况。对该患者坏死灶采用单一经壁入路（单腔道通路技术 - SGT）无效。第二次胃造瘘术采用与进入坏死灶的额外途径相同的微创技术（多腔道通路技术 - MTGT）。在所描述的病例中，由内镜多路经壁入路（MTGT）组成的新技术操作足够有效，并使患者完全康复。
