den Dekker N, Grüter A A J, van Oostendorp S E, Zonderhuis B M, Tuynman J B
Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, Location VUmc, De Boelelaan 1117, Postbus 7057, 1007 MB, Amsterdam, the Netherlands.
Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, Location VUmc, De Boelelaan 1117, Postbus 7057, 1007 MB, Amsterdam, the Netherlands.
Int J Surg Case Rep. 2020;73:157-160. doi: 10.1016/j.ijscr.2020.07.020. Epub 2020 Jul 15.
Approximately 5% of patients with acute pancreatitis develop infected necrotizing pancreatitis, with reported mortality rates up to 32%. Surgical interventions are postponed as long as possible, but if surgical debridement is needed the optimal approach has not been found yet.
A 47-year-old male was referred to our tertiary centre with infected necrotizing pancreatitis. Two months after initial presentation and repeated percutaneous drainage, surgical retroperitoneal debridement of the necrotic tissue was performed using a single incision laparoscopic surgery (SILS) port. Postoperatively, percutaneous drainage was performed two more times, but no additional surgical interventions were needed. The patient was discharged one month after the surgical procedure.
This is the first report of a minimally invasive technique using a SILS port for debridement of necrotizing pancreatitis. The ability to create a stable pneumo-retroperitoneum leads to optimal visualisation, better haemostasis, more space to operate in, better instrument handling, and better tissue control.
约5%的急性胰腺炎患者会发展为感染性坏死性胰腺炎，报告的死亡率高达32%。手术干预应尽可能推迟，但如果需要进行手术清创，尚未找到最佳方法。
一名47岁男性因感染性坏死性胰腺炎被转诊至我们的三级医疗中心。在初次就诊并反复经皮引流两个月后，使用单孔腹腔镜手术（SILS）端口对坏死组织进行了手术腹膜后清创。术后又进行了两次经皮引流，但无需额外的手术干预。患者在手术一个月后出院。
这是首次使用SILS端口进行坏死性胰腺炎清创的微创技术报告。建立稳定的气腹后腹膜的能力可实现最佳可视化、更好的止血效果、更大的操作空间、更好的器械操作以及更好的组织控制。
