ERCP术后十二指肠穿孔及其相关腹膜后感染诊治的研究进展  

Recent diagnostic and therapeutic advances of retroperitoneal infection in duodenal perforation after endoscopic retrograde cholangiopancreatography

作　　者：孟稼祥 李幼生[1] Meng Jiaxiang;Li Yousheng(Department of Surgery,Shanghai No.9 People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院普外科,上海200011

出　　处：《腹部外科》2024年第1期28-31,43,共5页Journal of Abdominal Surgery

基　　金：上海市青年科技英才扬帆计划(21YF1424800);上海交通大学医学院附属第九人民医院传染病与重症救治能力提升计划(CRZZ202002)。

摘　　要：十二指肠穿孔是经内镜逆行胰胆管造影(endoscopic retrograde cholangiopancreatogra-phy,ERCP)术后偶发但严重的并发症。早期临床症状常难以与术后胰腺炎和胆管炎鉴别,诊断延迟可导致腹膜后感染;而腹膜后间隙组织疏松,感染容易沿腹膜后间隙扩散,血运较差且易形成脓肿,引起脓毒症和多器官功能衰竭,伴随着住院时间长和较高的病死率;有效地对其进行诊断和治疗,病人的预后可得到极大的改善。此文结合国内外文献综述ERCP术后十二指肠穿孔和相关的腹膜后感染的临床表现和治疗方法。Duodenal perforation is an occasional and yet serious complication of endoscopic retrograde cholangiopancreatography(ERCP)and sphincterotomy.Its early clinical symptoms are often difficult to differentiate with those of postoperative pancreatitis and cholangitis.Delayed diagnosis and retroperitoneal infection may lead to sepsis and multiple organ failure with prolonged hospitalization and higher mortality.Loose intraperitoneal tissue easily spreads along retroperitoneal space and poor blood supply causes early abscess formation.An early diagnosis and timely interventions shall greatly improve patient outcomes.This review summarized the domestic and foreign literature on properly managing retroperitoneal infection in duodenal perforation after ERCP.

关 键 词：腹膜后感染 十二指肠穿孔 经内镜逆行胰胆管造影 括约肌切开术 微创治疗 

分 类 号：R656[医药卫生—外科学]