急性胰腺炎外科干预的时机及技术探讨

李非

doi:10.3969/j.issn.1001-5256.2017.01.006

急性胰腺炎外科干预的时机及技术探讨

DOI: 10.3969/j.issn.1001-5256.2017.01.006

李非

首都医科大学宣武医院普外科

详细信息

中图分类号: R657.51
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出版历程
- 收稿日期: 2016-11-01
- 出版日期: 2017-01-20

Timing and techniques of surgical intervention for acute pancreatitis: consensus and controversy

Li Fei

Department of General Surgery,Xuanwu Hospital,Capital Medical University

摘要

摘要: 急性胰腺炎病情复杂多变,早期以非手术治疗为主,但是早期针对急性胰腺炎的某些病因,需及时行外科干预,以控制其发病病因。而在急性胰腺炎发病中后期,针对局部并发症,讨论了外科治疗的时机,对经皮穿刺置管引流和视频辅助微创手术等技术的应用进行了探讨。微创手术和传统开腹手术孰优孰劣、如何合理选择视频辅助微创技术等方面目前还存有争议,今后需进行更深入的研究。
- 胰腺炎 /
- 外科手术 /
- 治疗
Abstract: Acute pancreatitis has uncertain and complicated conditions,and non- surgical treatment is mainly used during the early stage.However,as for the causes of acute pancreatitis in early stage,timely surgical intervention should be given to control some causes. This article also elaborates on the application of percutaneous drainage and video- assisted minimally invasive surgery. It is pointed out that there are still controversies over the advantages and disadvantages of minimally invasive surgery and conventional laparotomy and how to select video-assisted minimally invasive surgery,and that in depth studies are still needed in future.
- pancreatitis /
- surgical procedures /
- operative

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参考文献(16)

[1] Group of Pancreas Surgery,Chinese Society of Surgery,Chinese Medical Association.Guidelines for the management of acute pancreatitis(2014)[J].J Clin Hepatol,2015,31(1):17-20.(in Chinese)中华医学会外科学分会胰腺外科学组.急性胰腺炎诊治指南(2014)[J].临床肝胆病杂志,2015,31(1):17-20.

[2]TENNER S,BAILLIE J,DEWITT J,et al.American College of Gastroenterology guideline:management of acute pancreatitis[J].Am J Gastroenterol,2013,108(9):1400-1416.

[3]Working Group IAP/APA Acute Pancreatitis Guidelines.IAP/APA evidence-based guidelines for the management of acute pancreatitis[J].Pancreatology,2013,13(4 Suppl 2):e1-e15.

[4]KIRKPATRICK AW,ROBERTS DJ,DE WAELE J,et al.Intraabdominal hypertension and the abdominal compartment syndrome:updated consensus definitions and clinical practice guidelines from the World Society of the Abdominal Compartment Syndrome[J].Intensive Care Med,2013,39(7):1190-1206.

[5]RARATY MG,HALLORAN CM,DODD S,et al.Minimal access retroperitoneal pancreatic necrosectomy:improvement in morbidity and mortality with a less invasive approach[J].Ann Surg,2010,251(5):787-793.

[6]FREENY PC,HAUPTMANN E,ALTHAUS SJ,et al.Percutaneous CT-guided catheter drainage of infected acute necrotizing pancreatitis:techniques and results[J].AJR Am J Roentgenol,1998,170(4):969-975.

[7]van BAAL MC,van SANTVOORT HC,BOLLEN TL,et al.Systematic review of percutaneous catheter drainage as primary treatment for necrotizing pancreatitis[J].Br J Surg,2011,98(1):18-27.

[8]van SANTVOORT HC,BESSELINK MG,BAKKER OJ,et al.A step-up approach or open necrosectomy for necrotizing pancreatitis[J].N Engl J Med,2010,362(16):1491-1502.

[9]HOLLEMANS RA,BOLLEN TL,van BRUNSCHOT S,et al.Predicting success of catheter drainage in infected necrotizing pancreatitis[J].Ann Surg,2016,263(4):787-792.

[10]CASTELLANOS G,SERRANO A,PINERO A,et al.Retroperitoneoscopy in the management of drained infected pancreatic necrosis[J].Gastrointest Endosc,2001,53(4):514-515.

[11]LI A,CAO F,LI J,et al.Step-up mini-invasive surgery for infected pancreatic necrosis:results from prospective cohort study[J].Pancreatology,2016,16(4):508-514.

[12]LAKSHMANAN R,IYER SG,LEE VT,et al.Minimally invasive retroperitoneal pancreatic necrosectomy in the management of infected pancreatitis[J].Surg Laparosc Endosc Percutan Tech,2010,20(1):e11-e15.

[13]GOMATOS IP,HALLORAN CM,GHANEH P,et al.Outcomes from minimal access retroperitoneal and open pancreatic necrosectomy in 394patients with necrotizing pancreatitis[J].Ann Surg,2016,263(5):992-1001.

[14]HOOKEY LC,DEBROUX S,DELHAYE M,et al.Endoscopic drainage of pancreatic-fluid collections in 116 patients:a comparison of etiologies,drainage techniques,and outcomes[J].Gastrointest Endosc,2006,63(4):635-643.

[15]SAMPATH K,GARDNER TB.Transmural drainage approaches for pancreatic necrosis:a changing of the guard[J].Dig Endosc,2016.[Epub ahead of print]

[16]ISAYAMA H,NAKAI Y,RERKNIMITR R,et al.Asian consensus statements on endoscopic management of walled-off necrosis Part 1:epidemiology,diagnosis,and treatment[J].J Gastroenterol Hepatol,2016,31(9):1546-1554.引证本文:LI F.Timing and techniques of surgical intervention for acute pancreatitis:consensus and controversy[J].J Clin Hepatol,2017,33(1):32-35.(in Chinese)李非.急性胰腺炎外科干预的时机及技术探讨[J].临床肝胆病杂志,2017,33(1):32-35.

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