腹腔镜治疗外伤性胰腺炎。病例报告

Jesus David Sendoya-Vargas, M. J. Ruiz, Héctor Conrado-Jiménez
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摘要

外伤性胰腺炎(TP)占所有腹部创伤的不到10%,但死亡率和发病率分别高达34%和64%。TP的治疗采用保守方法,如果进展缓慢,则采用微创手术治疗。病例报告:一例54岁男性患者,右胁软骨钝性创伤,由于牛踢发展为中重度TP和四级胰腺损伤(PI)。他接受了两次腹腔镜手术,临床进展良好。他需要抗生素治疗19天,住院29天,其中9天在ICU。结论:胰脏位于腹膜后,诊断困难。这种情况的治疗通常是保守的,由于其低发病率和死亡率,首选经皮或内窥镜引流而不是手术引流的临床管理。对于这些患者,推荐的手术方法是剖腹手术;然而,腹腔镜方法是一种综合治疗的选择。
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Laparoscopy for traumatic pancreatitis. Case report
Introduction: Traumatic pancreatitis (TP) comprises less than 10% of all abdominal traumas but can reach mortality and morbidity rates of up to 34% and 64%, respectively. The treatment of TP has a conservative approach, followed by minimally invasive procedures and surgery if the evolution is torpid. Case report: A 54-year-old male patient with blunt trauma in right hypochondrium due to a bovine kick developed moderate-severe TP and grade IV pancreatic injury (PI). He underwent laparoscopic surgery twice with adequate clinical evolution. He required antibiotic therapy for 19 days and hospitalization for 29 days, of which 9 were in the ICU. Conclusion: The diagnosis of TP is difficult to achieve due to the retroperitoneal location of the pancreas. The treatment of this condition is usually conservative, preferring clinical management with percutaneous or endoscopic drainage over surgical drainage due to its low morbidity and mortality. The recommended surgical approach to these patients is laparotomy; however, the laparoscopic approach is a therapeutic option to be considered for comprehensive management.
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