Amodio Antonio, de Pretis Nicolò, De Marchi Giulia, Campagnola Pietro, Crucillà Salvatore, Caldart Federico, Frulloni Luca
University of Verona, Verona, Italy.
Intern Emerg Med. 2025 Apr 6. doi: 10.1007/s11739-025-03916-4.
Acute pancreatitis (AP) is an inflammatory disease that can represent a challenge for clinicians, in fact, the early determination of its severity in the first 72 h is crucial for prognosis, recognizing the etiology and carrying out risk stratification to determine a more specific therapy. No accurate early prognostic scores for disease severity have been published, so the severity of AP often cannot be properly defined in the first few hours of the disease. This initial phase represents a "no man's land", in which there is no certainty in the stratification of the damage, prognosis is difficult to establish, therapy must be started promptly, although there is still no effective medical therapy against pancreatic enzymatic activation. Therefore, it is very difficult at this stage to make the correct decisions to achieve the best outcome for the patient with AP. Literature search was carried out using the PubMed database by entering early management of acute pancreatitis [title] or therapy of acute pancreatitis [title] and selecting the most relevant articles for the diagnosis and therapy of acute pancreatitis in clinical practice. This document provides suggestions on managing the key clinical decisions for patients suffering from AP before disease severity is defined, to achieve the best outcomes for patients with AP.
急性胰腺炎（AP）是一种炎症性疾病，对临床医生来说可能是一项挑战。事实上，在最初72小时内尽早确定其严重程度对于预后至关重要，这需要识别病因并进行风险分层以确定更具针对性的治疗方法。目前尚未发表针对疾病严重程度的准确早期预后评分，因此在疾病最初几个小时内，AP的严重程度往往无法得到恰当界定。这一初始阶段就像是一片“无人区”，在此阶段，损伤分层尚无定论，预后难以确定，尽管目前仍没有针对胰腺酶激活的有效药物治疗，但必须迅速开始治疗。因此，在这个阶段，要为AP患者做出正确决策以实现最佳治疗效果非常困难。通过在PubMed数据库中输入“急性胰腺炎的早期管理”[标题]或“急性胰腺炎的治疗”[标题]进行文献检索，并选择临床实践中与急性胰腺炎诊断和治疗最相关的文章。本文档针对在明确疾病严重程度之前对AP患者关键临床决策的管理提供建议，以实现AP患者的最佳治疗效果。
