Evola Giuseppe, Vacante Marco, Evola Francesco Roberto, Reina Giuseppe Angelo, Maugeri Grazia, Musumeci Giuseppe, D'Agata Velia, Basile Guido
Chirurgia (Bucur). 2025 Jun;120(3):314-321. doi: 10.21614/chirurgia.3117.
Acute pancreatitis is a serious inflammatory condition of the pancreas that can be life-threatening, with the approach to treatment depending on the severity of the disease. Diagnosing acute pancreatitis, predicting its severity, and assessing prognosis generally involve imaging techniques like computed tomography, magnetic resonance imaging and ultrasound, along with scoring systems such as Ranson, Acute Physiology and Chronic Health Evaluation II (APACHE II), and the Bedside Index for Severity in Acute Pancreatitis (BISAP). Computed tomography is regarded as the gold standard due to its high sensitivity and specificity, while magnetic resonance imaging and ultrasound offer valuable insights into biliary obstruction and vascular issues. These scoring systems help categorize patients based on clinical and laboratory data into mild, moderate, or severe levels, influencing treatment decisions like intensive care unit admission, early enteral feeding, and the use of antibiotics. However, despite the importance of these imaging and scoring methods in managing acute pancreatitis, they face challenges in terms of accuracy, consistency, practicality, and cost-effectiveness. In this review we aimed at discussing the clinical usefulness of the most important scoring systems for prediction of severity in this complex disease.
急性胰腺炎是胰腺的一种严重炎症性疾病，可能危及生命，其治疗方法取决于疾病的严重程度。诊断急性胰腺炎、预测其严重程度以及评估预后通常涉及计算机断层扫描、磁共振成像和超声等成像技术，以及兰森评分、急性生理与慢性健康状况评分系统II（APACHE II）和急性胰腺炎床边严重程度指数（BISAP）等评分系统。计算机断层扫描因其高灵敏度和特异性而被视为金标准，而磁共振成像和超声则能为胆管梗阻和血管问题提供有价值的见解。这些评分系统有助于根据临床和实验室数据将患者分为轻度、中度或重度，从而影响诸如重症监护病房收治、早期肠内营养和抗生素使用等治疗决策。然而，尽管这些成像和评分方法在急性胰腺炎管理中很重要，但它们在准确性、一致性、实用性和成本效益方面面临挑战。在本综述中，我们旨在讨论最重要的评分系统对预测这种复杂疾病严重程度的临床实用性。
