Boumitri Christine, Brown Elizabeth, Kahaleh Michel
Division of Gastroenterology and Hepatology, Department of Medicine, University of Missouri, Columbia, MO, USA.
Division of Gastroenterology and Hepatology, Department of Medicine, Weill Cornell Medicine, New York, NY, USA.
Clin Endosc. 2017 Jul;50(4):357-365. doi: 10.5946/ce.2016.152. Epub 2017 May 16.
Acute necrotizing pancreatitis accounts for 10% of acute pancreatitis (AP) cases and is associated with a higher mortality and morbidity. Necrosis within the first 4 weeks of disease onset is defined as an acute necrotic collection (ANC), while walled off pancreatic necrosis (WOPN) develops after 4 weeks of disease onset. An infected or symptomatic WOPN requires drainage. The management of pancreatic necrosis has shifted away from open necrosectomy, as it is associated with a high morbidity, to less invasive techniques. In this review, we summarize the current management and therapies for acute necrotizing pancreatitis.
急性坏死性胰腺炎占急性胰腺炎(AP)病例的10%,且与更高的死亡率和发病率相关。疾病发作后4周内的坏死被定义为急性坏死性积聚(ANC),而包裹性胰腺坏死(WOPN)在疾病发作4周后形成。感染性或有症状的WOPN需要引流。胰腺坏死的管理已从开放性坏死组织清除术转变,因为该手术与高发病率相关,转而采用侵入性较小的技术。在本综述中,我们总结了急性坏死性胰腺炎的当前管理和治疗方法。