Department of Medicine, Robert Wood Johnson School of Medicine, New Brunswick, NJ, USA.
J Clin Gastroenterol. 2011 Aug;45(7):614-25. doi: 10.1097/MCG.0b013e318213ef3e.
The advent of computed tomographic scan with its wide use in the evaluation of acute pancreatitis has opened up a new topic in pancreatology i.e. fluid collections. Fluid collections in and around the pancreas occur often in acute pancreatitis and were defined by the Atlanta Symposium on Acute Pancreatitis in 1992. Two decades since the Atlanta Conference additional experience has brought to light the inadequacy and poor understanding of the terms used by different specialists involved in the care of patients with acute pancreatitis when interpreting imaging modalities and the need for a uniformly used classification system. The deficiencies of the Atlanta definitions and advances in medicine have led to a proposed revision of the Atlanta classification promulgated by the Acute Pancreatitis Classification Working Group. The newly used terms "acute peripancreatic fluid collections," "pancreatic pseudocyst," "postnecrotic pancreatic/peripancreatic fluid collections," and "walled-off pancreatic necrosis" are to be clearly understood in the interpretation of imaging studies. The current treatment methods for fluid collections are diverse and depend on accurate interpretations of radiologic tests. Management options include conservative treatment, percutaneous catheter drainage, open and laparoscopic surgery, and endoscopic drainage. The choice of treatment depends on a correct diagnosis of the type of fluid collection. In this study we have attempted to clarify the management and clinical features of different types of fluid collections as they have been initially defined under the 1992 Atlanta Classification and revised by the Working Group's proposed categorization.
计算机断层扫描的出现及其在急性胰腺炎评估中的广泛应用开创了胰腺病学的一个新课题,即液体积聚。胰腺及其周围的液体积聚在急性胰腺炎中经常发生,并在 1992 年的亚特兰大急性胰腺炎研讨会上得到了定义。自亚特兰大会议以来的二十年里,更多的经验表明,不同专业人员在解释影像学模式时,对用于描述急性胰腺炎患者护理的术语的理解存在不足和误解,因此需要使用统一的分类系统。亚特兰大定义的缺陷以及医学的进步导致了急性胰腺炎分类工作组提出的对亚特兰大分类的修订。新使用的术语“急性胰周液体积聚”、“胰腺假性囊肿”、“坏死后胰腺/胰周液体积聚”和“包裹性胰腺坏死”在解释影像学研究时需要明确理解。目前,对液体积聚的治疗方法多种多样,这取决于对放射学检查的准确解读。治疗选择包括保守治疗、经皮导管引流、开放和腹腔镜手术以及内镜引流。治疗的选择取决于对液体积聚类型的正确诊断。在这项研究中,我们试图阐明不同类型液体积聚的管理和临床特征,因为它们最初是根据 1992 年亚特兰大分类定义的,后来又被工作组提出的分类所修订。