【作者】 蔡阳； 陆贝； 万亚锋； 殷俊杰； 胡炜； 方建华；

【Author】 CAI Yang;LU Bei;Wan Ya-feng;YIN Jun-jie;HU Wei;FANG Jian-hua;Department of HPB Surgery,First People’s Hospital;

【机构】 杭州市第一人民医院；

【摘要】 目的 :探讨同时使用腹腔镜和经皮肾镜技术微创治疗胰腺周围脓肿的方法及疗效。方法 :回顾性分析自2015年6月至2018年6月我院首次同时采用腹腔镜和经皮肾镜技术治疗胰腺周围感染性坏死的11例资料。结果 :11例患者均采用术前B超或CT引导下经皮穿刺置管引导定位,再同时行腹腔镜和经皮肾镜胰腺周围脓肿清除术。其中2例患者接受2次肾镜手术和1次腹腔镜手术,5例接受3次肾镜和1次腹腔镜手术,4例接受4次肾镜手术和1次腹腔镜手术。1例患者术中并发窦道内出血,加做窦道扩大小切口止血,2例患者术后出现结肠漏行保守治疗痊愈。11例患者术后平均住院时间85d(60-165d),无死亡病例。结论 :同时腹腔镜加经皮肾镜胰周脓肿清除术创伤小,效果理想,符合精准医学及加速外科康复理论,是微创治疗感染坏死性胰腺炎的又一种理想双镜模式。更多还原

【Abstract】 Objective:To evaluate the effect of simultaneous operation of laparoscopic and percutaneous nephroscopic necrosectomy in the treatment of peripancreatic abscess.Methods:The clinical data of 11 patients with peripancreatic abscess treated by laparoscopic and percutaneous nephroscopic necrosectomy in our hospital from 2015.6 to 2018.6 were retrospectively analyzed.Results:11 patients were treated with percutaneous puncture and drainage under the guidance of B Ultrasound/ComputedTomography,and then underwent laparoscopic and percutaneous nephroscopic necrosectomy.2 patients tooktwiceofpercutaneous nephroscopic surgery and once of laparoscopic surgery,and 5 patients took 3 times of percutaneous nephroscopic surgery,and 4 patients took 4 times of percutaneous nephroscopic surgery and once of laparoscopic surgery.1 patient with percutaneous nephroscopic necrosectomy complicated with sinus tract hemorrhage,and add a hemostasis of small incision,2 patients of postoperative colon fistulawere cured by conservative treatment.The average length of hospital stay was 85 d(60-165 d) in 11 patients,no death case.Conclusion:Laparoscopic and percutaneous nephroscopic necrosectomy is a minimally invasive and effective method for the treatment of peripancreatic abscessin the case of a alternative choice,it’s in line with the theory of precision medicine and ERAS.更多还原