1.Percutaneous nephroscopic necrosectomy for post-operatively resident infection of severe acute pancreatitis.
Xianlei XIN ; Shouwang CAI ; Email: caisw8077.cai@ VIP.SINA.COM. ; Zhiwei LIU ; Lei HE ; Jian FENG ; Pengfei WANG ; Maosheng TANG ; Shichun LU ; Jiahong DONG
Chinese Journal of Surgery 2015;53(9):676-679
OBJECTIVETo investigate the method and effect of percutaneous nephroscopic necrosectomy (PNN) for post-operatively resident infection of severe acute pancreatitis (SAP).
METHODSData of the 15 SAP patients with post-operatively resident infection treated by PNN from June 2008 to December 2014 in Chinese People's Liberation Army General Hospital were reviewed. Twelve of the patients underwent the laparotomy within 1 week, 1 in 3(rd) week, 1 in 4(th) week and the other one on the 127(th) day. All of the referrals firstly received (multi-)percutaneous catheter drainage (PCD), and then PNN operation according to the disease, followed by continuous irrigation-drainage.
RESULTSEleven patients were healed after received only one PNN operation, 2 patients for twice, 1 for three times and 1 for four times. The average post-operative time of hospital stay was 66.2 days (10-223 days). The complications after operation contained colon fistula (n = 1), abdominal hemorrhage (n = 1), pancreatic pseudocyst (n = 1), severe pulmonary infection (n = 1). Three patients eventually died.
CONCLUSIONSPercutaneous nephroscopic necrosectomy is a minimally invasive approach which could prevent the complicated re-laparotomy operation, result in less complication. It is an ideal method for treating SAP patients with post-operatively resident infection.
Drainage ; Humans ; Laparoscopy ; Laparotomy ; Length of Stay ; Minimally Invasive Surgical Procedures ; Operative Time ; Pancreatitis, Acute Necrotizing ; complications ; surgery ; Postoperative Complications ; microbiology ; Reoperation
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