腹腔镜灌注引流术治疗早期重症急性胰腺炎分析

The analysis of laparoscopic intraperitoneal drainage in treatment of early severe acute pancreatitis

目的探讨腹腔镜坏死组织清除、置管灌洗引流术治疗早期重症急性胰腺炎(SAP)的效果。方法 2011年1月至2013年12月收治SAP患者19例,全部符合SAPⅡ级临床诊断标准;其中男性11例,女性8例,平均年龄56岁;胆源性胰腺炎5例,非胆源性胰腺炎14例。所有患者均早期经腹腔镜胰腺坏死组织清除、置管灌洗引流术并观察疗效。结果 19例SAP患者中,1例患者因多脏器功能衰竭死亡,1例患者发生胰漏,其余17例患者经治疗后血、尿淀粉酶及肠功能恢复正常后痊愈出院。结论 SAP患者早期腹腔粘连轻、腹腔积液未局限,而腹腔镜引流术快捷、对患者创伤小、术后康复快。腹腔镜手术效果与合理手术方式应遵循个体化原则,在熟练掌握腹腔镜操作技能的前提下开展腹腔镜手术治疗早期重症SAP,堪称安全、有效的治疗方式。

Objectives To study early the laparoscopic removal of necrotic tissue and lavage catheter drainage therapy in the severe acute pancreatitis (SAP). Methods From January 2011 to December 2013,there were admitted 19 patients with early SAP. Early laparoscopic pancreatic necrosis tissue removal,catheter drainage and irrigation efficacy were done for all patients. Results Within 19 patients,one case of death due to multiple organ failure,one case of pancreatic leak,and the remaining 17 cases were cured. Conclusion Laparoscopic surgery results and reasonable manner should follow the principle of individuation,the master carry out laparoscopic skills is premise of SAP laparoscopic surgery, which is a safe and effective treatment.