经自然腔道内镜下胰腺包裹性坏死引流清创术  

Endoscopic transmural drainage and necrosectomy of walled-off pancreatic necrosis

作　　者：何文华[1] 李罗娜 朱勇[1] 祝荫[1] 吕农华[1] Wen-hua He;Luo-na Li;Yong Zhu;Yin Zhu;Nong-hua Lyu(Department of Gastroenterology, the First Affiliated Hospital of Nanchang University,Nanchang, Jiangxi 330006, China)

机构地区：[1]南昌大学第一附属医院消化科,江西南昌330006

出　　处：《中国内镜杂志》2017年第3期83-87,共5页China Journal of Endoscopy

基　　金：国家临床重点专科建设项目[卫办医政函(2011)872号];江西省科技计划项目(No:20122BBG70121-1);江西省卫生计生委科技计划(No:20155112)

摘　　要：感染性胰腺坏死(IPN)是急性胰腺炎(AP)的严重局部并发症,其死亡率达32.0%。目前的共识认为对于怀疑或确诊的IPN,有创的干预治疗(包括经皮引流、内镜或手术)应尽可能推迟至发病4周后进行,使坏死组织液化并形成包裹性坏死(WON)。随着内镜技术发展,经自然腔道(胃或十二指肠)内镜下引流及清创术已被国内外指南推荐为WON的首选方法之一。该文详细阐述了WON的诊断与评估;内镜下引流与清创术的适应证、禁忌证、操作步骤、术后评估和并发症处理,最后介绍了近年内镜引流与清创治疗的研究进展。pancreatic necrosis(IPN)is a serious complication of acute pancreatitis(AP),with a mortalityreported to be as great as32.0%.At present,it is considered that patients with proven or suspected infectednecrotizing pancreatitis,invasive intervention(i.e.percutaneous catheter drainage,endoscopic transluminal drainage/necrosectomy,minimally invasive or open necrosectomy)should be delayed where possible until at least4weeksafter initial presentation to allow the collection to become‘walled-off’.With the development of endoscopictechnology,endoscopic transmural(stomach or duodenum)drainage and necrosectomy has been recommendedas one of the preferred methods for walled-off necrosis.This article introduces the diagnosis and evaluation of thewalled-off necrosis;the indications,operation procedures,postoperative evaluation and management of postoperativecomplications of endoscopic transmural drainage and necrosectomy.At last,the research progress of endoscopicdrainage and debridement in recent years was introduced.

关 键 词：急性胰腺炎 包裹性坏死 内镜引流术 内镜清创术 

分 类 号：R576[医药卫生—消化系统]