Huang Zhu, Tang Lijun
PLA Center for General Surgery, Key Laboratory of Pancreatic Injury and Repair of Sichuan Province, General Hospital of Chengdu Military Command, Chengdu 610083, China.
PLA Center for General Surgery, Key Laboratory of Pancreatic Injury and Repair of Sichuan Province, General Hospital of Chengdu Military Command, Chengdu 610083, China.Email:
Zhonghua Wei Chang Wai Ke Za Zhi. 2018 Dec 25;21(12):1361-1365.
The peripancreatic infection is a severe complication during severe acute pancreatitis. Early diagnosis, effective prevention and timely treatment are directly associated to prognosis. In recent years, with the promotion and application of the concept of damage control and the rapid development of imaging intervention techniques, the treatment for peripancreatic infection has become "multi-step, step-up" minimally invasive surgical strategy from early laparotomy. The transformation of this concept and method has significantly improved the efficacy of peripancreatic infection in clinical practice. However, there are still many problems to be solved, such as prophylactic antibiotics, the choice of minimally invasive surgical techniques, and the management of early ascites. In addition, due to the variability and complexity of the course of severe acute pancreatitis, there is no uniform standard for clinical treatment and management of peripancreatic infection. Only through multidisciplinary collaboration, including surgery, imaging, nutrition and intensive care, can we truly achieve appropriate risk assessment, accurate clinical diagnosis and effective individualized treatment for these patients.
胰腺周围感染是重症急性胰腺炎期间的一种严重并发症。早期诊断、有效预防和及时治疗直接关系到预后。近年来，随着损伤控制理念的推广应用以及影像介入技术的快速发展，胰腺周围感染的治疗已从早期开腹手术转变为“多步骤、递进式”的微创手术策略。这一理念和方法的转变在临床实践中显著提高了胰腺周围感染的治疗效果。然而，仍有许多问题有待解决，如预防性抗生素的使用、微创手术技术的选择以及早期腹水的管理等。此外，由于重症急性胰腺炎病程的多变性和复杂性，胰腺周围感染的临床治疗和管理尚无统一标准。只有通过包括外科、影像、营养和重症监护等多学科协作，才能真正对这些患者进行恰当的风险评估、准确的临床诊断和有效的个体化治疗。
