Application Of Pancreatic Duct Stenting And Naso-pancreatic Duct Drainage(Sequential Therapy)in The Treatment Of Acute Necrotizing Pancreatitis

Objective To evaluate the efficacy and safety of endoscopic pancreatic stenting and naso-pancreatic duct drainage(sequential therapy)in the treatment of Acute Necrotizing Pancreatitis(ANP).Methods Retrospective analysis of clinical data of patients with ANP undergoing sequential therapy at Ningxia Medical University general hospital from 31 December 2015 to31 December 2020,White blood cells(WBC)、amylase(AMY)and APACHE II were recorded before and after operation,and other surgical interventions were still needed after sequential treatment.The outcome was analyzed.The treatment effect was evaluated by using SPSS 22.0 software.Results A total of 43 cases were included,including 72.1%(31/43)males,27.9%(12/43)of females.The rate of biliary pancreatitis was 65.1%(28/43),The proportion of biliary associated with other etiology was 11.6%(5/43).The median time between endoscopic pancreatic stenting and naso-pancreatic duct drainage was 14(8-41)days,APACHE II score,WBC count and AMY were significantly decreased(p < 0.05),None of the 43 patients had endoscopic complications.16 patients(27.2%)were cured by sequential therapy,And no other surgical intervention such as puncture and drainage or necrotic tissue removal is required.Five patients(11.6%)died,3 of whom died of abdominal hemorrhage,2 of whom died of multiple organ failure(MOF),34(79.1%)were cured,and 4(9.3%)were asymptomatic.Conclusion Patients with ANP can be cured by sequential therapy,and some patients can avoid other surgical interventions such as puncture and drainage,necrotic tissue removal,,At the same time,sequential therapy can reduce the local and systemic inflammation of pancreas without increasing the risk of adverse events and death.It can be used as a safe,minimally invasive and effective therapy for ANP.