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. 2023 Jan 1;61(1):13-17. doi: 10.3760/cma.j.cn112139-20220901-00373.
Infected pancreatic necrosis(IPN) is the main surgical indication of acute pancreatitis. Minimally invasive debridement has become the mainstream surgical strategy of IPN,and it is only preserved for IPN patients who are not response for adequate non-surgical treatment. Transluminal or retroperitoneal drainage is preferred,and appropriate debridement can be performed. At present,it is reported that video assisted transluminal,trans-abdominal and retroperitoneal approaches can effectively control IPN infection. However,in terms of reducing pancreatic leakage and other complications,surgical and endoscopic transgastric debridement may be the future direction in the treatment of IPN.
感染性胰腺坏死(IPN)是急性胰腺炎的主要手术指征。微创清创术已成为IPN的主流手术策略,仅适用于对充分的非手术治疗无反应的IPN患者。首选经腔或腹膜后引流,并可进行适当的清创。目前有报道称,视频辅助经腔、经腹和腹膜后入路可有效控制IPN感染。然而,在减少胰瘘等并发症方面,外科和内镜经胃清创术可能是IPN治疗的未来方向。