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内镜、透壁引流和坏死组织清除术用于无壁胰腺和胰周坏死与低死亡率相关-一个单中心的经验

作者:陈亚云 编译 来源:医学论坛网 日期:2015-03-23
导读

         Endoscopic, transmural drainage and necrosectomy for walled-off pancreatic and peripancreatic necrosis is associated with low mortality a single-center experience Palle Nordblad Schmidt,Srdan Novov

 

Endoscopic, transmural drainage and necrosectomy for walled-off pancreatic and peripancreatic necrosis is associated with low mortality – a single-center experience

Palle Nordblad SchmidtSrdan NovovicStine Roug, and Erik Feldager

Abstract

Objective. Endoscopic transmural drainage and necrosectomy (ETDN) is a promising alternative to percutaneous drainage and surgical intervention in the treatment of walled-off pancreatic and peripancreatic necroses (WONs). We assessed the outcome and safety profile of ETDN in a single-center patient cohort. Materials and methods. In November 2005, ETDN for WON was introduced in our tertiary referral center. During a 6-year period (Nov 2005–Nov 2011), we retrospectively collected data on all patients who underwent ETDN. Results. Eighty-one patients were treated with ETDN (median age 54, 52 men). Gallstones were the predominant etiology of pancreatitis (41%), followed by alcohol (33%). Median time from debut of symptoms to first endoscopic treatment was 44 (9–246) days. Culture-proven infected necrosis was found in 71% of the cases. Twenty-three patients (28%) required admission in intensive care unit. The technical and clinical success rates were 99% and 89%, respectively. Procedure-related complications occurred in 10 (12%) patients, of which 1 was procedure-related death. In-hospital mortality was 11%. Conclusion. ETDN in patients with necrotizing pancreatitis and infected necrosis performed in a single, high-volume center has an acceptable safety profile and is associated with a low mortality.

Scandinavian Journal of Gastroenterology
May 2015, Vol. 50, No. 5 , Pages 611-618 (doi:10.3109/00365521.2014.946078)



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