腹腔镜治疗暴发性重症急性胰腺炎

Treatment of fulminant severe acute pancreatitis with laparoscope

目的探讨腹腔镜用于治疗暴发性重症急性胰腺炎(fulminant severe acutepancreatitis,FSAP)手术时机、方法及疗效。方法回顾分析我院采用腹腔镜手术治疗的11例FSAP的病人临床资料。腹腔镜下分离胃结肠韧带,进入网膜腔暴露胰腺,吸净渗出液,冲洗腹腔,清除胰腺坏死组织,网膜囊及盆腔置入灌洗管和多根引流管,术后用大量生理盐水持续灌洗引流至引出的灌洗液澄清。结果治愈8例,3例死于多器官功能衰竭,住院时间42-92天,平均58天。结论积极采用腹腔镜对FSAP进行手术治疗,可有效地改善FSAP的预后,是一种安全有效的治疗方法。

Objective To investigate the operative timing, procedure and therapeutic effects of laparoscopic intervention for fulminant severe acute pancreatitis （F SAP）. Methods Eleven cases with FSAP received treatment of laparoscope were retrospectively analyzed. The gastrocolic ligament was opened under laparoscope. The pancreas was exposed clearly,then removing all exudations and pancreatic necrosis tissue. Drainage and irrigating catheters were placed around the pancreas and pelvic cavity. Large volumes of normal saline were used to lavage until the abdominal fluid became clear. Results Eight patients recovered completely and 3 patient died of multi-system organ failure. The length of hospital stay was 42 to 92 days and mean hospital stay was 58 days. Conclusion The FSAP treatment with laparoscopic treatment could improve the prognosis, and appears to be an safe and effective approach.