Abstract: 【Abstract】〓Objective〓Necrotizing pancreatitis (NP) patients frequently underwent pancreatic debr-idement with risk factors for incisional hernia (IH). However, no published data exist the regarding incidence of IH in NP. The aim of the current study was to define the incidence of and identify risk factors for developing IH after pancreatic debridement. Methods〓Hernia presence was determined by clinical examination and patient interview. Technical and clinical considerations were noted: type of incision, closure, suture material, age, body mass index (BMI), diabetes mellitus (DM), preoperative albumin, and number of operations. Results〓Sixty-three (42%) of 149 debrided patients with NP developed IH. IH patients were older than those without IH(P<0.05). No differences in surgical technique or clinical risk factors were seen between groups. Conclusion〓The incidence of IH in NP patients requiring operative debridement is substantially higher than that in patients undergoing routine laparotomy. Innovative fascial closure techniques such as primary fascial buttress with nonsynthetic mesh should be considered.

Key words: Incisional hernia, Ventral hernia, Risk factors, Necrotizing pancreatitis, Pancreatic debridement

摘要： 【摘要】〓目的〓坏死性胰腺炎(NP)患者经常需要胰腺清创,并且有发生切口疝(IH)的风险。然而,目前尚未见关于坏死性胰腺炎中切口疝发生率的相关报道。我们研究的目的是明确其发病率,并且确定胰腺清创后IH发生的危险因素。方法〓通过临床查体及病人访谈确定IH的存在。技术及临床方面的数据包括:切口类型,关腹方式,缝线材料,年龄,身体质量指数(BMI),糖尿病(DM),术前白蛋白水平及手术次数。结果〓149例胰腺清创患者中63例(42%)发生了IH,且IH患者多为老年(P<0.05)。在外科手术方式或临床危险因素方面组间未见差异。结论 需要手术清创的NP患者IH的发病率要显著高于常规剖腹探查者。具有创新性的筋膜关闭技术,如非合成补片进行初次手术筋膜支撑,应予关注。

关键词: 切口疝, 腹壁疝, 危险因素, 坏死性胰腺炎, 胰腺清创