腹腔镜经胃胰腺坏死组织清除治疗胰腺包裹性坏死的研究进展

Laparoscopic transgastric necrosectomy in treatment of wall-off pancreatic necrosis

微创外科和内镜"进阶"胰腺坏死组织清除已成为胰腺包裹性坏死合并感染的首选手术方式。外科清创具有高效、费用低、可及性好的特点,而内镜下治疗后胰瘘、切口疝等并发症发生率低。腹腔镜经胃胰腺坏死组织清除术(LTGN)结合了外科与内镜下清创的优势,可能成为未来坏死性胰腺炎外科治疗的重要术式之一。本文重点介绍LTGN的技术优势、手术要点、适应证与应用现状,为LTGN的技术推广提供参考。

Mini-invasive surgical or endoscopic step-up approach is the first choice of pancreatic necrosectomy for infected wall-off necrosis.Surgical debridement has the advantage of high efficiency,low cost and good accessibility,while the complication rate of pancreatic fistula and incision hernia after endoscopic necrosectomy is low.Laparoscopic transgastric necrosectomy(LTGN)can combine the advantages of surgical and endoscopic debridement,and may become one of the important methods for the surgical treatment of necrotizing pancreatitis in the future.This paper focuses on the technical advantages,surgical points,indications and application status of LTGN,so as to provide reference for the technical promotion.