经后上腰腹膜后路行重症急性胰腺炎感染坏死组织清除引流术

Debridement and drainage of infected necrosis for severe acute pancreatitis via lumbo-retroperitoneal route

目的:探讨重症急性胰腺炎(severe acute pancreatitis,SAP)合并胰周感染时,手术清除感染坏死组织及引流路径和方法。方法:分析总结我科从2003年1月至2007年12月收治的28例SAP并胰周感染患者,采用经后上腰腹膜后路清除引流及术后灌洗治疗的临床资料。结果:4例经过1次手术,21例经过2次手术,3例经过3次手术,所有病人均经术后灌洗后痊愈或好转出院,无死亡病例。术后有消化道出血1例,肠瘘1例,胰瘘2例。结论:SAP合并胰周感染时,采用经后上腰腹膜后路行感染坏死组织清除引流和术后灌洗是直接、安全、有效的治疗方法。

Objective To determine the route and ways of debridement and drainage of infected necrosis for severe acute pancreatitis （SAP） combined with pancreatic infection. Methods Clinical data of 28 patients with SAP accompanied with secondary pancreatic infection, who underwent lumbo-retroperitoneal debridement, drainage and lavage after the operation were retrospectively investigated. Results Four patients underwent one operation, 21 underwent 2 operations, and 3 underwent 3 operations. All patients recovered or improved and were discharged by postoperative lavage Four patients had complications, including 1 gastrointestinal bleeding, 1 intestinal fistula and 2 pancreatic fistula. Conclusion Debridement and drainage of infected necrosis for SAP combined with pancreatic infection via lumbo-retroperitoneal route is direct, safe and effective.