Sui Y H, Lu T Q, Sun B
Department of Pancreatic and Biliary Surgery,the First Affiliated Hospital of Harbin Medical University,Key Laboratory of Hepatosplenic Surgery,Ministry of Education,Harbin 150001,China.
Zhonghua Wai Ke Za Zhi. 2022 Jul 1;60(7):660-665. doi: 10.3760/cma.j.cn112139-20220326-00126.
Infected pancreatic necrosis (IPN) is a crucial reason for the poor prognosis of patients with acute pancreatitis,which is complicated and difficult to predict the outcomes. Surgery is an important way to cure IPN,and "step-up approach" is the mainstream mode of IPN treatment. In the era of minimally invasive surgery,the full course endoscopic treatment of IPN has been gradually hot and achieved good outcomes as endoscopic technology' improvement. However,it is controversial that whether technique is better for IPN by surgery debridement or endoscopy drainage,and there is no consensus on the scope of applicability and the timing of intervention. The paper aims to explore the intervention methods,indications and timing of endoscopic and surgical treatment of IPN and elaborate the selection strategies of them in clinical practice,so as to develop individualized treatment options,accurately implement minimally invasive intervention and improve the prognosis.
感染性胰腺坏死（IPN）是急性胰腺炎患者预后不良的关键原因，其病情复杂且难以预测预后。手术是治疗IPN的重要手段，“逐步升级法”是IPN治疗的主流模式。在微创手术时代，随着内镜技术的进步，IPN的全程内镜治疗逐渐受到关注并取得了良好疗效。然而，手术清创与内镜引流哪种技术对IPN更优仍存在争议，在适用范围和干预时机上也未达成共识。本文旨在探讨IPN内镜及手术治疗的干预方法、适应证及时机，并阐述其在临床实践中的选择策略，以制定个体化治疗方案，精准实施微创干预并改善预后。
