Clinical study of no necrotic cavity lavage after debridement and drainage in patients with infected pancreatic necrosis
10.3760/cma.j.issn.0529-5815.2018.07.006
- VernacularTitle:感染性胰腺坏死清创引流术后脓腔不灌洗的临床效果
- Author:
Chongchong GAO
1
;
Feng CAO
;
Diangang LIU
;
Kuo LIANG
;
Jia LI
;
Ang LI
;
Xiaohui WANG
;
Chunxiu WANG
;
Zhe WANG
;
Ning DUAN
;
Yuduo WU
;
Fei LI
Author Information
1. 首都医科大学宣武医院普外科
- Keywords:
Pancreatitis,acute necrotizing;
Bacterial infections;
Infected pancreatic necrosis;
No necrotic cavity lavage;
Large caliber-wide channel drainage
- From:
Chinese Journal of Surgery
2018;56(7):512-515
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the outcomes of no necrotic cavity lavage after debridement and drainage in patients with infected pancreatic necrosis (IPN).Methods From February 2014 to August 2017,there were 89 patients who were diagnosed as IPN undergoing minimally invasive surgery with no necrotic cavity lavage and large caliber-wide channel drainage in Department of General Surgery,Xuanwu Hospital,Capital Medical University.There were 57 male and 32 female patients aging of (49.5± 14.4)years (ranging from 23 to 84 years).The body mass index of 89 patients was (25.4± 3.8) kg/m2 (ranging from 17.6 to 36.7 kg/m2).Among the 89 patients,37 cases(41.6％) of biliary pancreatitis,10 cases (11.2％) of alcoholic pancreatitis,16 cases (18.0％) of hyperlipidemic pancreatitis,and 26 cases (29.2％) of other reasons.Results Of 89 patients,IPN in 6 patients (6.7％) resolved using only percutaneous catheter drainage;another 83 patients underwent laparoscopic debridement (n =3,3.4％) or video-assisted debridement (n =80,89.9％).No patient was conversed to laparotomy.The average operation frequency and surgery time was (2.3±1.7) times and (56.5±31.7) minutes.The median bleeding volume and total length of stay was 10(0-600) ml and 34(6-172) days separately.The complication rate(Clavien-Dindo grade ≥Ⅲ) was 9.0％ (8/89) which involved mainly abdominal hemorrhage (5/8) and digestive tract fistula formation (3/8).The overall mortality rate was 6.7％ (6/89).Among them,3 cases died of abdominal infection,bacteremia and multiple organ failure,2 cases died of pulmonary infection and bacteremia and 1 case died of fungal infection.Conclusion No necrotic cavity lavage after debridement and drainage operation is considered effective and safe for IPN patients.
