腹膜后入踣手术治疗胰腺坏死并感染的安全性及疗效分析

目的 探讨腹膜后入路手术治疗胰腺坏死并感染的方法、安全性及疗效.方法 分析2008年1月至2013年3月9例重症急性胰腺炎（serious acute pancreatitis,SAP）发生胰腺坏死并感染在局麻或者全麻下实施了腹膜后入路胰腺坏死组织清除引流术患者的临床资料.5例经过1次手术,4例经过2次手术；8例首次手术为双侧清除引流,1例为单侧.结果 术后患者全身中毒症状迅速缓解,无任何并发症发生,首次手术时间60～80 min,平均（73±5.7） min,随访期间8例患者症状均完全消失,无复发,1例患者于术后6周死于心肌梗塞.结论 对于重症急性胰腺炎发生胰腺坏死并感染的患者,腹膜后入路行胰腺坏死组织清除引流术是直接、安全、有效、可行的治疗方法.

Security and efficacy of surgical treatment via retroperitoneum route for infected pancreatic necrosis

Objective To investigate the method,security and efficacy of surgical treatment via retroperitoneum route for infected pancreatic necrosis.Methods The clinical data of 9 patients with serious acute pancreatitis（SAP）and infected pancreatic necrosis who underwent necrosectomy via retro peritoneum route between January 2008 and March 2013 were analyzed retrospectively.Five patients underwent the primary operation and 4 patients underwent the secondary operation additionally.Eight patients received bilateral necrosectomy and 1 patient received the unilateral surgery.Results After the operation,the systemic toxic symptoms of all patients alleviated rapidly and no complication occured.The first operation time ranged from 60 to 80 minutes with an average of（72 ± 5.8） minutes.During the follow-up period,8 patients lived without symptoms or recurrence.One patient died of myocardial infarction six weeks after operation.Conclusion For patients with SAP and infected pancreatic necrosis,the operation via retroperitoneum route is a direct,secure,efficient and feasible method.