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欧洲重症急性胰腺炎治疗手术策略调查

European survey of surgical strategies for the management of severe acute pancreatitis.

作者信息

King Nicolas K K, Siriwardena Ajith K

机构信息

Hepatobiliary Unit, Department of Surgery, Manchester Royal Infirmary, Manchester M13 9WL, UK.

出版信息

Am J Gastroenterol. 2004 Apr;99(4):719-28. doi: 10.1111/j.1572-0241.2004.04111.x.

Abstract

OBJECTIVES

This study is the first pan-European survey of surgical strategies for the management of severe acute pancreatitis.

METHODS

A questionnaire survey was undertaken of the 866 members of the European chapter of the International Hepato-Pancreato-Biliary Association (IHPBA). There were 329 replies from practicing clinicians giving a response rate of 38%.

RESULTS

The modal case volume was 11-20 patients per year. Severity stratification was used by 324 (99%) respondents with the Ranson score being the most popular. Antibiotic prophylaxis was utilized by 239 (73%) with the median duration being 7 days (range 1-28; 95% CI: 8-9). Fine needle aspiration of necrosis was undertaken by 174 (53%) and 131 would operate on a patient with a positive result. There was no consensus on optimum timing of surgery.

CONCLUSIONS

The results of this first pan-European questionnaire demonstrate wide variations in care. Overall, the findings provide a unique insight into the current management of severe acute pancreatitis in Europe.

摘要

目的

本研究是首次针对重症急性胰腺炎管理的全欧洲外科治疗策略调查。

方法

对国际肝胆胰协会(IHPBA)欧洲分会的866名成员进行了问卷调查。有329名执业临床医生回复,回复率为38%。

结果

每年处理病例数的众数为11 - 20例患者。324名(99%)受访者采用了严重程度分层,其中兰森评分是最常用的。239名(73%)受访者采用了抗生素预防,中位持续时间为7天(范围1 - 28天;95%置信区间:8 - 9天)。174名(53%)受访者进行了坏死组织细针穿刺抽吸,其中131名会对结果呈阳性的患者进行手术。对于最佳手术时机没有达成共识。

结论

首次全欧洲问卷调查的结果显示了治疗方法的广泛差异。总体而言,这些发现为欧洲目前重症急性胰腺炎的管理提供了独特的见解。

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