Acute necrotizing pancreatitis(ANP)is a critical type of acute pancreatitis(AP)[1,2].ANP has high mortality,long-term hospitalization,high cost,and potential morbidity[3,4].Infected or symptomatic necrosis continually...Acute necrotizing pancreatitis(ANP)is a critical type of acute pancreatitis(AP)[1,2].ANP has high mortality,long-term hospitalization,high cost,and potential morbidity[3,4].Infected or symptomatic necrosis continually requires debridement as the mainstay of treatment when percutaneous drainage fails[5].With the advent of minimally invasive approaches in recent decades,surgical management of pancreatic necrosis has been advanced.Guidelines recommend using a step-up approach instead of direct open pancreatic necrosectomy(OPN)[6].Endoscopic drainage and necrosectomy are appropriate for walled-offnecrosis(WON)near the stomach or duodenum[7].Minimal access retroperitoneal pancreatic necrosectomy(MARPN)is a good approach for laterally located WON that is distant from the stomach or duodenum[8].However,these minimally invasive approaches are still not satisfactory.The repeatedly debridement itself causes necrosis.Generally,large pieces of necrosis are not easy to clear,and blood vessels are difficult to distinguish.Risks of bleeding,gastrointestinal fistula,and pancreatic fistula are still inevitable.展开更多
文摘Acute necrotizing pancreatitis(ANP)is a critical type of acute pancreatitis(AP)[1,2].ANP has high mortality,long-term hospitalization,high cost,and potential morbidity[3,4].Infected or symptomatic necrosis continually requires debridement as the mainstay of treatment when percutaneous drainage fails[5].With the advent of minimally invasive approaches in recent decades,surgical management of pancreatic necrosis has been advanced.Guidelines recommend using a step-up approach instead of direct open pancreatic necrosectomy(OPN)[6].Endoscopic drainage and necrosectomy are appropriate for walled-offnecrosis(WON)near the stomach or duodenum[7].Minimal access retroperitoneal pancreatic necrosectomy(MARPN)is a good approach for laterally located WON that is distant from the stomach or duodenum[8].However,these minimally invasive approaches are still not satisfactory.The repeatedly debridement itself causes necrosis.Generally,large pieces of necrosis are not easy to clear,and blood vessels are difficult to distinguish.Risks of bleeding,gastrointestinal fistula,and pancreatic fistula are still inevitable.
