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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Front Med    2011, Vol. 5 Issue (3) : 302-305    https://doi.org/10.1007/s11684-011-0145-7
RESEARCH ARTICLE
Treatment of severe acute pancreatitis through retroperitoneal laparoscopic drainage
Chun Tang, Baolin Wang, Bing Xie, Hongming Liu, Ping Chen()
Department of Hepatobiliary Surgery, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing 400042, China
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Abstract

A treatment method based on drainage via retroperitoneal laparoscopy was adopted for 15 severe acute pancreatitis (SAP) patients to investigate the feasibility of the method. Ten patients received only drainage via retroperitoneal laparoscopy, four patients received drainage via both retroperitoneal and preperitoneal laparoscopy, and one patient received drainage via conversion to laparotomy. Thirteen patients exhibited a good drainage effect and were successfully cured without any other surgical treatment. Two patients had encapsulated effusions or pancreatic pseudocysts after surgery, but were successfully cured after lavage and B ultrasound-guided percutaneous catheter drainage. SAP treatment via retroperitoneal laparoscopic drainage is an effective surgical method, resulting in minor injury.

Keywords severe acute pancreatitis (SAP)      laparoscope      retroperitoneal drainage      treatment     
Corresponding Author(s): Chen Ping,Email:chenping@263.net   
Issue Date: 05 September 2011
 Cite this article:   
Baolin Wang,Bing Xie,Hongming Liu, et al. Treatment of severe acute pancreatitis through retroperitoneal laparoscopic drainage[J]. Front Med, 2011, 5(3): 302-305.
 URL:  
https://academic.hep.com.cn/fmd/EN/10.1007/s11684-011-0145-7
https://academic.hep.com.cn/fmd/EN/Y2011/V5/I3/302
Fig.1  A 44-year old male patient was hospitalized on July 27, 2009 after he suffered from pain in the upper abdomen. The results of his physical examination are as follows: a slight abdominal bulge, full left abdomen, pressing and jumping pain and muscular tension in the upper abdomen, positive shifting dullness, and weakened bowel sound. A routine blood examination showed a WBC of 8.60 × 10, blood amylase of 45.1 U/L, and urine amylase of 405.9 U/L.
Fig.2  Two days after hospitalization, the 44-year-old patient received a retroperitoneal laparascopic drainage around the pancreas under general anesthesia. During the surgery, the anterior pararenal space around the pancreas was dissociated and a light bloody fluid of about 500 ml flowed out. The necrotic tissues around the pancreas were removed with an aspirator. Two drainage tubes were then arranged: one tube was placed at the tail of the pancreas, whereas the other was placed at the posterior pararenal space. The tubes were then led out from the puncture holes. After a month, the patient has recovered based on CT examination.
1 Besselink MG, de Bruijn MT, Rutten JP, Boermeester MA, Hofker HS, Gooszen HG, Dutch Acute Pancreatitis Study Group. Surgical intervention in patients with necrotizing pancreatitis. Br J Surg 2006; 93(5): 593–599
doi: 10.1002/bjs.5287 pmid:16521173
2 McKay CJ. Recent developments in the management of acute pancreatitis. Dig Surg 2002; 19(2): 129–134
doi: 10.1159/000052027 pmid:11979001
3 Takeda K, Matsuno S, Sunamura M, Kobari M. Surgical aspects and management of acute necrotizing pancreatitis: recent results of a cooperative national survey in Japan. Pancreas 1998; 16(3): 316–322
doi: 10.1097/00006676-199804000-00018 pmid:9548673
4 Takeda K, Mikami Y, Fukuyama S, Egawa S, Sunamura M, Ishibashi T, Sato A, Masamune A, Matsuno S. Pancreatic ischemia associated with vasospasm in the early phase of human acute necrotizing pancreatitis. Pancreas 2005; 30(1): 40–49
pmid:15632698
5 Mentula P, Hienonen P, Kemppainen E, Puolakkainen P, Lepp?niemi A. Surgical decompression for abdominal compartment syndrome in severe acute pancreatitis. Arch Surg 2010; 145(8): 764–769
doi: 10.1001/archsurg.2010.132 pmid:20713929
6 Hunter JD, Damani Z. Intra-abdominal hypertension and the abdominal compartment syndrome. Anaesthesia 2004; 59(9): 899–907
doi: 10.1111/j.1365-2044.2004.03712.x pmid:15310355
7 De Waele JJ, Delrue L, Hoste EA, De Vos M, Duyck P, Colardyn FA. Extrapancreatic inflammation on abdominal computed tomography as an early predictor of disease severity in acute pancreatitis: evaluation of a new scoring system. Pancreas 2007; 34(2): 185–190
doi: 10.1097/mpa.0b013e31802d4136 pmid:17312456
8 van Santvoort HC, Besselink MG, Bollen TL, Buskens E, van Ramshorst B, Gooszen HG, Dutch Acute Pancreatitis Study Group. Case-matched comparison of the retroperitoneal approach with laparotomy for necrotizing pancreatitis. World J Surg 2007; 31(8): 1635–1642
doi: 10.1007/s00268-007-9083-6 pmid: PMID:17572838
9 Ai X, Qian X, Pan W, Xu J, Hu W, Terai T, Sato N, Watanabe S. Ultrasound-guided percutaneous drainage may decrease the mortality of severe acute pancreatitis. J Gastroenterol 2010; 45(1): 77–85
doi: 10.1007/s00535-009-0129-4 pmid:19787287
10 Szentkereszty Z, Sápy P. The role of percutaneous external drainage in the treatment of fluid collections associated with severe acute pancreatitis. What, when and how to drain? Orv Hetil 2007; 148(30): 1395–1399 (in Hungarian)
doi: 10.1556/OH.2007.27999 pmid: PMID:17631476
11 Heiss P, Bruennler T, Salzberger B, Lang S, Langgartner J, Feuerbach S, Schoelmerich J, Hamer OW. Severe acute pancreatitis requiring drainage therapy: findings on computed tomography as predictor of patient outcome. Pancreatology 2010; 10(6): 726–733
doi: 10.1159/000320710 pmid:21242714
12 Rettally CA, Skarda S, Garza MA, Schenker S. The usefulness of laboratory tests in the early assessment of severity of acute pancreatitis. Crit Rev Clin Lab Sci 2003; 40(2): 117–149
doi: 10.1080/713609331 pmid:12755453
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