چکیده (انگلیسی):

Objective: To explore the effect of retroperitoneal laparoscopic debridement and
drainage on infected necrosis in severe acute pancreatitis.
Materials and methods: This retrospective study included 18 patients with severe acute
pancreatitis (SAP) undergoing retroperitoneal laparoscopic debridement and drainage from
May 2006 to April 2012 in our hospital. All patients had infected retroperitoneal necrosis and
single or multiple peritoneal abscesses. Eleven patients transferred to our hospital were
treated with the retroperitoneal laparoscopic debridement and drainage within 24e72 hours
after admission. Conservative treatments were given to eight patients. Retroperitoneal laparoscopic
debridement and drainage were applied 3e11 days after admission.
Results: All patients had infection of necrotic pancreas or peripancreatic tissues. Twelve patients
had organ failure. Three patients underwent secondary surgery. Laparotomy with
debridement and drainage were applied to one patient who had a huge lesser sac abscess 7
days after first surgery. The other two patients were given secondary retroperitoneal laparoscopic
debridement and drainage. One case was complicated by retroperitoneal hemorrhage,
four cases had pancreatic leakage, and no intestinal fistula was found. The patients’ heart
rate, respiration, temperature, and white blood cell count were significantly improved 48
hours after surgery compared with those prior to surgery (p<0.05). The average length of stay
in hospitals was 40.8 days (range, 6e121 days), and the drainage tube indwelling time was 44.4
days (range, 2e182 days).
Conclusion: Retroperitoneal laparoscopic debridement and drainage is an SAP surgical treatment
with a minimally invasive procedure and a good effect, and can be applied for infected
retroperitoneal necrosis in early SAP.