Servicio de Aparato Digestivo. Hospital Universitario Virgen de las Nieves, Granada, España.
Servicio de Aparato Digestivo. Hospital Universitario Virgen de las Nieves, Granada, España.
Med Clin (Barc). 2022 Jun 10;158(11):556-563. doi: 10.1016/j.medcli.2021.12.012. Epub 2022 Mar 8.
Acute pancreatitis is nowadays one of the most common diseases among gastroenterology disorders, being gallstones and alcohol the main etiologies. Diagnostic criteria and indications of different imaging techniques are well defined, so that abdominal ultrasound is useful for etiological diagnosis whereas computarized tomography is better for risk stratification and local complications assessment. Goal directed fludtherapy, early starting of oral feeding and pain management are the mainstay of early treatment in acute pancreatitis. Antibiotics are useful when infected necrosis or extra pancreatic infections are documented or suspected but no as prophylaxis in sterile necrotizing pancreatitis. Minimally invasive approaches have emerged in the last decade for walled off necrosis management, improving complication rates, quality of life and length of hospital stay when compared with open surgery.
如今,急性胰腺炎是消化内科最常见的疾病之一,主要病因是胆石症和酒精。不同影像学技术的诊断标准和适应证已明确界定,因此腹部超声有助于病因诊断,而计算机断层扫描(CT)则更有利于风险分层和局部并发症评估。急性胰腺炎的早期治疗主要包括目标导向的液体治疗、早期开始口服喂养和疼痛管理。当感染性坏死或胰腺外感染有明确证据或疑似时,抗生素有用,但在无菌性坏死性胰腺炎中不作为预防用药。在过去十年中,微创方法已应用于包裹性坏死的管理,与开放性手术相比,可改善并发症发生率、生活质量和住院时间。