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胰腺坏死:并发症与治疗的变化趋势

Pancreatic necrosis: Complications and changing trend of treatment.

作者信息

Rashid Mamoon Ur, Hussain Ishtiaq, Jehanzeb Sundas, Ullah Waqas, Ali Saeed, Jain Akriti Gupta, Khetpal Neelam, Ahmad Sarfraz

机构信息

Department of Internal Medicine, Advent Health Graduate Medical Education, Orlando, FL 32804, United States.

Department of Gastroenterology, Cleveland Clinic, Weston, FL 33326, United States.

出版信息

World J Gastrointest Surg. 2019 Apr 27;11(4):198-217. doi: 10.4240/wjgs.v11.i4.198.

Abstract

Incidence of acute pancreatitis seems to be increasing in the Western countries and has been associated with significantly increased morbidity. Nearly 80% of the patients with acute pancreatitis undergo resolution; some develop complications including pancreatic necrosis. Infection of pancreatic necrosis is the leading cause of death in these patients. A significant portion of these patients needs surgical interventions. Traditionally, the "gold standard" procedure has been the open surgical necrosectomy, which is now being completed by the relatively lesser invasive interventions. Minimally invasive surgical (MIS) procedures include endoscopic drainage, percutaneous image-guided catheter drainage, and retroperitoneal drainage. This review article discusses the open and MIS interventions for pancreatic necrosis with each having its own respective benefits and disadvantages are covered.

摘要

在西方国家,急性胰腺炎的发病率似乎呈上升趋势,且与发病率显著增加相关。近80%的急性胰腺炎患者病情会得到缓解;部分患者会出现包括胰腺坏死在内的并发症。胰腺坏死感染是这些患者死亡的主要原因。这些患者中有很大一部分需要手术干预。传统上,“金标准”手术是开放性手术坏死组织清除术,现在相对微创的干预措施正逐渐取代它。微创手术(MIS)包括内镜引流、经皮影像引导下导管引流和腹膜后引流。本文综述了针对胰腺坏死的开放性手术和微创手术干预措施,同时阐述了各自的优缺点。

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