Department of Surgery, Teikyo University School of Medicine, 2-11-1, Kaga-cho, Itabashi, Tokyo, 173-8605, Japan.
J Hepatobiliary Pancreat Sci. 2010 Jan;17(1):3-12. doi: 10.1007/s00534-009-0216-1. Epub 2009 Dec 18.
Considering that the Japanese (JPN) guidelines for the management of acute pancreatitis were published in Takada et al. (J HepatoBiliary Pancreat Surg 13:2-6, 2006), doubts will be cast as to the reason for publishing a revised edition of the Guidelines for the management of acute pancreatitis: the JPN guidelines 2010, at this time. The rationale for this is that new criteria for the severity assessment of acute pancreatitis were made public on the basis of a summary of activities and reports of shared studies that were conducted in 2008. The new severity classification is entirely different from that adopted in the 2006 guidelines. A drastic revision was made in the new criteria. For example, about half of the cases that have been assessed previously as being 'severe' are assessed as being 'mild' in the new criteria. The JPN guidelines 2010 are published so that consistency between the criteria for severity assessment in the first edition and the new criteria will be maintained. In the new criteria, severity assessment can be made only by calculating the 9 scored prognostic factors. Severity assessment according to the contrast-enhanced computed tomography (CT) grade was made by scoring the poorly visualized pancreatic area in addition to determining the degree of extrapancreatic progress of inflammation and its extent. Changes made in accordance with the new criteria are seen in various parts of the guidelines. In the present revised edition, post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis is treated as an independent item. Furthermore, clinical indicators (pancreatitis bundles) are presented to improve the quality of the management of acute pancreatitis and to increase adherence to new guidelines.
考虑到日本（JPN）急性胰腺炎管理指南已于 2006 年 Takada 等人发表（J HepatoBiliary Pancreat Surg 13:2-6），此时发布《急性胰腺炎管理指南》修订版的原因令人怀疑。这样做的理由是，根据 2008 年开展的活动和共同研究报告的总结，公布了新的急性胰腺炎严重程度评估标准。新的严重程度分类与 2006 年指南中采用的完全不同。新标准进行了大幅度修订。例如，在新标准中，以前评估为“严重”的约一半病例被评估为“轻度”。发布日本指南 2010 是为了保持第一版严重程度评估标准与新标准之间的一致性。在新标准中，只能通过计算 9 个评分的预后因素进行严重程度评估。根据增强 CT（CT）分级进行严重程度评估，除了确定炎症的胰腺外进展程度及其范围外，还对胰腺区域的低可视性进行评分。根据新标准进行的更改在指南的各个部分都可见到。在本修订版中，内镜逆行胰胆管造影（ERCP）后胰腺炎被视为一个独立的项目。此外，还提出了临床指标（胰腺炎包），以提高急性胰腺炎的管理质量并提高对新指南的遵从性。
