目的 探索采用腹膜后入路经皮肾镜治疗感染性胰腺坏死的方法并评价其疗效.方法 2008年6月至2009年8月采用经皮肾镜治疗感染性胰腺坏死6例,均先行腹膜后途径PCD治疗5～36 d,进一步行经PCD窦道的经皮肾镜坏死清除、引流治疗.结果 3例病人接受1次肾镜治疗,2例接受2次治疗,1例接受3次治疗.无手术并发症,无手术病死.1例半年后形成假性囊肿.结论 病例选择合适情况下经腹膜后途径经皮肾镜治疗感染性胰腺坏死的方法简单、创伤小、疗效较好,值得进一步深入探索.%Objective Infected pancreatic necrosis is a serious complication of necrotizing pancreatitis. A method of minimally-invasive retroperitoneal infected pancreatic necrosectomy using percutaneous nephroscope was evaluated. Methods 21 patients with acute pancreatitis were treated in our hospital from June 2008 to August 2009. Among 13 patients who developed infected pancreatic necrosis, 6 underwent percutaneous catheter drainage by CT guidance. Then retroperitoneal infected pancreatic necrostectomy using percutaneous nephroscope along the sinus tract were performed after drainage for 5-36 d. Results In these 6 patients, 3 received percutaneous nephroscopic treatment one time, 2 two times and 1 three times. There were no operative mortality and morbidity except that 1 patient developed pseudocyst 6 months after operation. Conclusion Retroperitoneal pancreatic necrosectomy by percutaneous nephroscope is a safe, feasible, minimally-invasive and efficient method for treating infected pancreatic necrosis when the indication and occasion are suitable. This method would be a valid therapeutic option for treating necrotizing pancreatitis. However, further evaluation is necessary.
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