Cao F, Li F
Department of General Surgery,Xuanwu Hospital,Capital Medical University,Clinical Center for Acute Pancreatitis,Capital Medical University,Beijing 100053,China.
Zhonghua Wai Ke Za Zhi. 2022 May 1;60(5):432-435. doi: 10.3760/cma.j.cn112139-20211117-00537.
Mini-invasive surgical or endoscopic step-up approach is the first choice of pancreatic necrosectomy for infected wall-off necrosis. Surgical debridement has the advantage of high efficiency,low cost and good accessibility,while the complication rate of pancreatic fistula and incision hernia after endoscopic necrosectomy is low.Laparoscopic transgastric necrosectomy(LTGN) can combine the advantages of surgical and endoscopic debridement,and may become one of the important methods for the surgical treatment of necrotizing pancreatitis in the future. This paper focuses on the technical advantages,surgical points,indications and application status of LTGN,so as to provide reference for the technical promotion.
微创外科或内镜逐步升级方法是感染性包裹性坏死性胰腺炎坏死组织清除术的首选。外科清创具有高效、低成本和易操作的优点,而内镜下坏死组织清除术后胰瘘和切口疝的发生率较低。腹腔镜经胃坏死组织清除术(LTGN)可兼具外科和内镜清创的优势,可能成为未来坏死性胰腺炎外科治疗的重要方法之一。本文重点阐述LTGN的技术优势、手术要点、适应证及应用现状,以期为该技术的推广提供参考。