老年重症胰腺炎经腹腔镜腹腔置管灌洗引流治疗体会

TREATMENT OF OLDER SEVERE ACUTE PANCREATITIS BY PERITONEAL LAVAGE AND DRAINAGE THROUGH LAPAROSCOPE

目的 :探索老年重症胰腺炎 (OSAP)微创外科治疗的可能性 ,时机方法和疗效。方法 :运用微创外科腹腔镜技术对 2 1例OSAP患者实施腹腔镜灌洗引流治疗 ,其中胆源性 15例 ,胰源性 6例。结果 :本组灌洗时间最短 7d ,最长 11d ,停止灌洗后逐日拔除引流管 ,通过上述治疗 ,半年后随访无并发症发生 ;OSAP经腹腔镜灌洗治疗创伤小 ,术后恢复快 ,安全 ,快捷 ,有效。 2 1例病人 18例治愈 ,3例死于术后多脏器功能衰竭。结论 :OS AP经腹腔镜灌洗引流如掌握好适应症 ,在熟练掌握腹腔镜操作技能的前提下OSAP腹腔镜手术治疗 ,是安全有效的。

Objective: To investigate the feasibility, opportunity, method and therapeutic effectiveness of microtraumatic surgical treatment for older (senile)severe acute pancreatitis(OSAP). Methods: Twenty-one patients with OSAP, in which 15 patients were biliogenic and 6 patients were pancreatogenic, were treated by peritoneal lavage and drainage through laparoscope and the treatment lasted 7～11days. Results: Eighteen patients were cure and had no complications during half year' follow up;3 patients were dead due to multiorgan function failure, the characteristics of laparoscopic operation for treating OSAP were safe, quick and effective. Conclusion: Peritoneal lavage and drainage through laparoscope is an effective method for treating patients with OSAP.