Estudiante de Posgrado Cirugía General, Pontificia Universidad Javeriana, Facultad de Medicina, Carrera 6A #51A-48, Bogotá D.C, 111711, Colombia.
Cirugía General, Pontificia Universidad Javeriana, Facultad de Medicina, Hospital Universitario San Ignacio, Bogotá, Colombia.
BMC Surg. 2024 Oct 7;24(1):293. doi: 10.1186/s12893-024-02586-x.
Acute pancreatitis (AP) is a common and potentially lethal disease. Approximately 10-20% of the patients progress to necrotizing pancreatitis (NP). The step-up approach is the gold standard approach to managing an infected necrotizing pancreatitis with acceptable morbidity and mortality rates. Video-assisted retroperitoneal debridement (VARD) has been described as a safe and feasible approach with high success rates. Multiple studies in the American, European, and Asian populations evaluating the outcomes of VARD have been published; nevertheless, outcomes in the Latin American population are unknown. This study aims to describe a single-center experience of VARD for necrotizing pancreatitis in Colombia with a long-term follow-up.
A prospective cohort study was conducted between 2016 and 2024. All patients over 18 years old who underwent VARD for necrotizing pancreatitis were included. Demographic, clinical variables, and postoperative outcomes at 30-day follow-up were described.
A total of 12 patients were included. The mean age was 55.9 years old (SD 13.73). The median follow-up was 365 days (P25 60; P75 547). Bile origin was the most frequent cause of pancreatitis in 90.1% of the patients. The mean time between diagnosis and surgical management was 78.5 days (SD 22.93). The mean size of the collection was 10.5 cm (SD 3.51). There was no evidence of intraoperative complications. The mean in-hospital length of stay was 65.18 days (SD 26.46). One patient died in a 30-day follow-up. One patient presented an incisional hernia one year after surgery, and there was no evidence of endocrine insufficiency at the follow-up.
According to our data, the VARD procedure presents similar outcomes to those reported in the literature; a standardized procedure following the STEP-UP procedure minimizes the requirement of postoperative drainages. Long-term follow-up should be performed to rule out pancreatic insufficiency.
急性胰腺炎（AP）是一种常见且可能致命的疾病。约 10-20%的患者进展为坏死性胰腺炎（NP）。升阶梯方法是管理感染性坏死性胰腺炎的金标准方法，具有可接受的发病率和死亡率。视频辅助腹膜后清创术（VARD）已被描述为一种安全且可行的方法，成功率很高。已经发表了多项针对美国、欧洲和亚洲人群的 VARD 疗效评估研究；然而，拉丁美洲人群的结果尚不清楚。本研究旨在描述哥伦比亚一家单中心 VARD 治疗坏死性胰腺炎的经验，并进行长期随访。
进行了一项 2016 年至 2024 年的前瞻性队列研究。纳入所有因坏死性胰腺炎接受 VARD 的 18 岁以上患者。描述了 30 天随访时的人口统计学、临床变量和术后结果。
共纳入 12 例患者。平均年龄为 55.9 岁（SD 13.73）。中位随访时间为 365 天（P25 60；P75 547）。胆汁来源是胰腺炎最常见的病因，占 90.1%。诊断与手术治疗之间的平均时间为 78.5 天（SD 22.93）。收集物的平均大小为 10.5cm（SD 3.51）。术中无并发症证据。平均住院时间为 65.18 天（SD 26.46）。1 例患者在 30 天随访时死亡。1 例患者在手术后 1 年出现切口疝，随访时无内分泌功能不全的证据。
根据我们的数据，VARD 手术的结果与文献报道的结果相似；遵循 STEP-UP 程序的标准化程序可最大程度减少术后引流的需求。应进行长期随访以排除胰腺功能不全。
