Jiang R, Gao C C, Bai J, Li A, Wang X H, Cao F, Li F
Department of General Surgery,Xuanwu Hospital,Capital Medical University;Clinical Center for Acute Pancreatitis, Capital Medical University, Beijing 100053, China.
Zhonghua Wai Ke Za Zhi. 2024 Oct 1;62(10):971-975. doi: 10.3760/cma.j.cn112139-20240418-00192.
Pancreatic cancer patients often have complaints such as upper abdominal pain and obstructive jaundice when seeking diagnosis and treatment. However, acute pancreatitis as a rare initial clinical manifestation of pancreatic cancer is often overlooked in clinical practice. This oversight often leads to a delayed diagnosis of pancreatic cancer, uncertainty in treatment strategies, and significantly affects patients' quality of life and prognosis. Therefore, early diagnosis and treatment, and active follow-up are crucial for patients with acute pancreatitis as an initial symptom of pancreatic cancer. Upon admission to such patients, common causes such as gallstones, alcohol abuse, and hyperlipidemia should be initially ruled out. Evaluation with tumor markers, CT and MRI, and endoscopic ultrasound are essential to confirm the diagnosis of pancreatic cancer. For patients with mild pancreatitis, managing peripancreatic inflammation first before radical resection of pancreatic cancer could reduce postoperative complications. Moreover, pancreatitis serves as a high-risk factor for pancreatic cancer, so it is crucial to closely follow up patients with pancreatitis to detect pancreatic cancer early.
胰腺癌患者在寻求诊断和治疗时通常会有上腹部疼痛和梗阻性黄疸等症状。然而，急性胰腺炎作为胰腺癌罕见的初始临床表现，在临床实践中常被忽视。这种疏忽往往导致胰腺癌的诊断延迟、治疗策略的不确定性，并显著影响患者的生活质量和预后。因此，对于以急性胰腺炎为初始症状的胰腺癌患者，早期诊断和治疗以及积极的随访至关重要。收治此类患者时，应首先排除胆石症、酗酒和高脂血症等常见病因。通过肿瘤标志物、CT和MRI以及内镜超声进行评估对于确诊胰腺癌至关重要。对于轻度胰腺炎患者，在胰腺癌根治性切除术前先处理胰腺周围炎症可减少术后并发症。此外，胰腺炎是胰腺癌的高危因素，因此对胰腺炎患者进行密切随访以早期发现胰腺癌至关重要。
