Jha Ashish K, Goenka Mahesh K, Kumar Ramesh, Suchismita Arya
Department of Gastroenterology Indira Gandhi Institute of Medical Sciences Patna India.
Department of Gastrosciences, Institute of Gastrosciences, Apollo Gleneagles Hospital Kolkata India.
JGH Open. 2018 Dec 7;3(1):80-88. doi: 10.1002/jgh3.12109. eCollection 2019 Feb.
Approximately 20% of patients with acute pancreatitis develop pancreatic necrosis. The presence of necrosis in a pancreatic collection significantly worsens the prognosis. Pancreatic necrosis is associated with high mortality and morbidity. In the last few decades, there has been a significant revolution in the treatment of infected pancreatic necrosis. A step-up approach has been proposed, from less invasive procedures to the operative intervention. Minimally invasive treatment modalities such as endoscopic drainage and necrosectomy, percutaneous drainage, and minimally invasive surgery have recently replaced open surgical necrosectomy as the first-line treatment option. Endoscopic intervention for pancreatic necrosis is being increasingly performed with good success and a lower complication rate. However, techniques of endotherapy are still not uniform and vary as per local expertise, and there are still many unresolved questions with regard to the interventions in patients with pancreatic necrosis. The objective of this paper is to critically review the literature and update the concepts of endoscopic interventional therapy of pancreatic necrosis.
约20%的急性胰腺炎患者会发生胰腺坏死。胰腺积液中存在坏死会显著恶化预后。胰腺坏死与高死亡率和高发病率相关。在过去几十年中，感染性胰腺坏死的治疗发生了重大变革。已提出一种逐步升级的方法，从侵入性较小的程序到手术干预。诸如内镜引流和坏死组织清除术、经皮引流以及微创手术等微创治疗方式最近已取代开放手术坏死组织清除术成为一线治疗选择。针对胰腺坏死的内镜干预越来越多地被实施，且成功率高、并发症发生率低。然而，内镜治疗技术仍不统一，因地区专业知识而异，并且在胰腺坏死患者的干预方面仍有许多未解决的问题。本文的目的是批判性地回顾文献并更新胰腺坏死内镜介入治疗的概念。
