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微创入路腹膜后胰腺坏死组织清除术:操作技术与围术期管理OA北大核心CSTPCD

Minimal access retroperitoneal pancreatic necrosectomy:operative techniques and perioperative management

中文摘要英文摘要

微创入路腹膜后胰腺坏死组织清除术(MARPN)是基于肾镜或软质内镜等可视化设备,以窦道作为手术路径,对腹膜后、胰周坏死组织进行清除的一种治疗感染性胰腺坏死(IPN)的微创手术方法,但其普及性仍有待提高,其适应证、具体技术细节、术后管理等方面还需进一步研究和探讨.在国内外一些大规模的胰腺外科中心,包括笔者所在中心,MARPN已经成为治疗IPN的主要手段,并且从已发表的数据来看均取得了较好疗效.笔者所在中心经过多年的探索和实践,对于MARPN已积累大量病例和经验,并对手术的步骤、流程和技术细节进行了标准化和规范化.在此,笔者就MARPN的操作技术及围术期管理进行介绍,以期该技术更为广泛、安全、有效地开展.

Minimally access retroperitoneal pancreatic necrosectomy(MARPN)is a minimally invasive surgical approach for the treatment of infected pancreatic necrosis(IPN),in which necrotic tissue behind the peritoneum and around the pancreas is cleared using visualized equipment such as nephroscope or flexible endoscope,with the sinus tract as the surgical pathway.However,its popularity still needs to be improved,and further research and discussion are needed on its indications,specific technical details,and postoperative management.In some large-scale pancreatic surgery centers at home and abroad,including the authors'center,MARPN has become the main means of treating IPN,and from the published data,it has shown good therapeutic effects.After years of exploration and practice,the authors'center has accumulated a large number of cases and experiences in MARPN surgery and standardized the steps,procedures,and technical details of the surgery.Here,the authors introduce the operative technique and perioperative management of MARPN,hoping to promote the wider,safer,and more effective implementation of this technique.

朱帅;魏伟;黄耿文

中南大学湘雅医院 普通外科胰腺外科/国家老年疾病临床医学研究中心(湘雅),长沙 410008

临床医学

胰腺炎,急性坏死性;病灶感染;清创术;最小侵入性外科手术

Pancreatitis,Acute Necrotizing;Focal Infection;Debridement;Minimally Invasive Surgical Procedures

《中国普通外科杂志》 2024 (003)

321-329 / 9

湖南省自然科学基金面上基金资助项目(2023JJ30885).

10.7659/j.issn.1005-6947.2024.03.002

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