Minimally invasive treatment for crade Ⅲ&Ⅳ blunt pancreatic injuries
10.3760/cma.j.cn113884-20210305-00084
- VernacularTitle:Ⅲ、Ⅳ级胰腺钝性损伤微创治疗的探讨
- Author:
Jian FENG
1
;
Zhiwei LIU
;
Shouwang CAI
;
Xianlei XIN
;
Jiye CHEN
;
Pengfei WANG
;
Weizheng REN
;
Lei HE
;
Huanxian MA
Author Information
1. 解放军总医院肝胆胰外科医学部，北京 100853
- Keywords:
Pancreas;
Wounds and injuries;
Hemodynamics;
Conservative treatment;
Minimally invasive surgical procedures
- From:
Chinese Journal of Hepatobiliary Surgery
2021;27(12):909-912
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the strategy and efficacy using minimally invasive treatment for grade Ⅲ&Ⅳ blunt pancreatic injuries.Methods:Retrospective data retrieved from medical records of 13 patients with grade Ⅲ&Ⅳ blunt pancreatic injuries who underwent minimally invasive treatment at the Chinese PLA General Hospital from July 2011 to June 2019 were analysed. There were 10 males and 3 females, aged (38±9) years. Minimally invasive treatment included percutaneous catheter drainage (PCD) and minimal-access retroperitoneal pancreatic necrosectomy (MARPN). Date from enrolled patients were anylsed.Results:There were 9 patients suffering from grade Ⅲ injuries and 4 patients suffering from grade Ⅳ injuries. On initial conservative treatment of these 13 patients, all developed local complications. The local complications were treated using minimally invasive treatment strategies: 13 patients underwent PCD. The median intervention time for PCD was 25 days after trauma; 10 patients were further treated with MARPN, and the median intervention time of MARPN was 41 days after trauma. Twelve patients recovered well and were discharged home. One patient died. The mortality rate was 7.7% (1/13). The median postoperative hospital stay was 19 days.Conclusion:For patients with pancreatic grade Ⅲ&Ⅳ injuries who were hemodynamically stable and had no other associated gastrointestinal injuries, initial conservative treatment, followed by subsequent minimally invasive treatment based on MARPN technology could be used to treat local complications.
