Abstract: ［Abstract］ Objective To report an experience of retroperitoneal laparoscopic dilatation and drainage of pancreatic bed combine with retroperitoneal pancreatic necrosectomy in the treatment of severe acute pancreatitis and sum up the experiences. Methods The clinical data of 4 cases of severe acute pancreatitis in our hospital from 2015- 2017 were analyzed retrospectively. Two cases treated with retroperitoneal laparoscopic pancreatic lavage drainge, and 2 cases with retroperitoneal laparoscopic pancreatic lavage drainge and pancreatic necrotic tissue clearance（MARPN）. Results One patient discontinued surgery due to a loss of pneumoperitoneum after intraoperative peritoneal rupture. The remaining 3 patients were successfully completed the operation. One patient had postoperative pancreatic fistula, and a pseudocyst around the pancreas was formed and resolved spontaneously through conservative treatment. Conclusion It is worthy of further study that retroperitoneal laparoscopic dilatation and drainage of pancreatic bed in the early stage of SAP, whether to plus with MARPN decided by the actual situation.

Key words: retroperitoneal laparoscopy, severe acute pancreatitis, dilatation and drainage of pancreatic bed

摘要： ［摘要］目的 观察后腹腔镜下胰床引流术+MARPN方案治疗SAP疗效及总结经验。方法 分析我科2015~2017年治疗4例SAP病人临床资料，其中2例行后腹腔镜下胰床扩创灌洗引流治疗，2例行后腹腔镜下胰床扩创行胰腺坏死组织清除+灌洗引流。结果 1例患者因术中后腹膜裂口导致气腹丧失而终止手术，其余3例患者顺利完成手术；1例术后发生胰瘘，保守治疗后形成胰腺周围假性囊肿，6个月后自行消退。结论 早期后腹腔镜下胰床引流术可作为治疗重症急性胰腺炎分期微创手术的一种术式。

关键词: 胰床扩创引流, 后腹腔镜, 重症急性胰腺炎