Department of General Surgery, University of Heidelberg, Heidelberg, Germany.
Infect Dis Clin North Am. 2010 Dec;24(4):921-41, viii. doi: 10.1016/j.idc.2010.07.011.
Acute pancreatitis is an inflammatory disease that is mild and self-limiting in about 80% of cases. However, severe necrotizing disease still has a mortality of up to 30%. Differentiated multimodal treatment concepts are needed for these patients, including a multidisciplinary team (intensivists, gastroenterologists, interventional radiologists, and surgeons). The primary therapy is supportive. Patients with infected pancreatic necrosis who are septic undergo interventional or surgical treatment, ideally not before the fourth week after onset of symptoms. This article reviews the pathophysiologic mechanisms of acute pancreatitis and describes clinical pathways for diagnosis and management based on the current literature and guidelines.
急性胰腺炎是一种炎症性疾病，约 80%的病例为轻度和自限性。然而，严重的坏死性疾病仍有高达 30%的死亡率。这些患者需要差异化的多模式治疗方案，包括多学科团队（重症医学科医生、胃肠病学家、介入放射科医生和外科医生）。主要治疗方法是支持性治疗。有感染性胰腺坏死且脓毒症的患者需要进行介入或手术治疗，最好是在症状发作后第四周之前不要进行。本文综述了急性胰腺炎的病理生理机制，并根据现有文献和指南描述了诊断和管理的临床路径。
