감염된 괴사성 췌장염에 대해 시행된 복강경 괴사제거술

• Published in: Annals of surgical treatment and research Vol. 74; no. 5; pp. 387 - 391
• Main Authors: 윤유석(Yoo-Seok Yoon), 한호성(Ho-Seong Han), 신상현(Sang-Hyun Shin), 조재영(Jai Young Cho), 강창권(Jiang Chang Quan), 장진영(Jin-Young Jang), 김선회(Sun-Whe Kim)
• Format: Journal Article
• Language: Korean
• Published: 대한외과학회 01.05.2008
• Subjects: 일반외과학; Necrosectomy; Necrotizing pancreatitis; Laparoscopy
• ISSN: 2288-6575; 2288-6796

Infected pancreatic necrosis is generally considered as an indication for surgical management, and this condition has traditionally been treated by laparotomy. However, open surgery still has high morbidity and mortality rates. The application of minimally invasive surgery to this disease entity has been recently tried with the possibility of incurring less morbidity. Herein we report on two cases of successful laparoscopic necrosectomy for treating infected pancreatic necrosis. Two patients developed acute necrotizing pancreatitis that involved the neck, body and tail of the pancreas after heavy drinking. Initially, percutanous drainage (PCD) was performed for these lesions. However, surgical debridement was decided on due to the patients’ non-responsiveness to medical treatment and infection was documented in the drainage fluid. Laparoscopic necrosectomy was performed using 5 trocars. The transmesocolic approach was adopted for the lesion around the pancreas body and tail, and the transgastrocolic approach was used for the lesion around the pancreas neck. The operation time was 190 and 225 minutes, respectively. There was no mortality. Although a pancreatic fistula occurred in one patient, it was improved by conservative management. Our cases show the technical feasibility and effectiveness of laparoscopic necrosectomy, but more experience is needed for this procedure to become a useful treatment option for infected pancreatic necrosis. (J Korean Surg Soc 2008;74:387-391) KCI Citation Count: 2