State University of New York, Health Sciences Center, Brooklyn, New York, USA.
Mayo Clinic, Rochester, Minnesota, USA.
Am J Gastroenterol. 2024 Mar 1;119(3):419-437. doi: 10.14309/ajg.0000000000002645. Epub 2023 Nov 7.
Acute pancreatitis (AP), defined as acute inflammation of the pancreas, is one of the most common diseases of the gastrointestinal tract leading to hospital admission in the United States. It is important for clinicians to appreciate that AP is heterogenous, progressing differently among patients and is often unpredictable. While most patients experience symptoms lasting a few days, almost one-fifth of patients will go on to experience complications, including pancreatic necrosis and/or organ failure, at times requiring prolonged hospitalization, intensive care, and radiologic, surgical, and/or endoscopic intervention. Early management is essential to identify and treat patients with AP to prevent complications. Patients with biliary pancreatitis typically will require surgery to prevent recurrent disease and may need early endoscopic retrograde cholangiopancreatography if the disease is complicated by cholangitis. Nutrition plays an important role in treating patients with AP. The safety of early refeeding and importance in preventing complications from AP are addressed. This guideline will provide an evidence-based practical approach to the management of patients with AP.
急性胰腺炎（AP）定义为胰腺的急性炎症，是美国导致住院的最常见胃肠道疾病之一。临床医生应该认识到，AP 是异质性的，在不同患者中进展情况不同，而且往往不可预测。虽然大多数患者的症状持续数天，但近五分之一的患者将出现并发症，包括胰腺坏死和/或器官衰竭，有时需要延长住院时间、重症监护以及放射、外科和/或内镜介入。早期管理对于识别和治疗 AP 患者以预防并发症至关重要。患有胆源性胰腺炎的患者通常需要手术以预防疾病复发，如果疾病并发胆管炎，则可能需要早期内镜逆行胰胆管造影。营养在治疗 AP 患者中起着重要作用。本文将探讨早期喂养的安全性以及在预防 AP 并发症中的重要性。本指南将提供一种基于循证的实用方法来管理 AP 患者。
