Baker C C, Huynh T
Department of Surgery, University of North Carolina School of Medicine, Chapel Hill.
Crit Care Clin. 1995 Apr;11(2):311-22.
In general, the best approach to pancreatitis is to recognize its presence early, resuscitate the patient aggressively, and employ nutritional and medical therapy to avoid complications. Nonetheless, either because of trauma or failure of medical therapy, some patients develop complications (e.g., hemorrhagic or necrotizing pancreatitis, abscess, pseudocyst, or fistula) that require operative intervention. Expert surgical judgment is required to decide which patients require surgery, when to operate, and what operation(s) to perform. Many of these patients require multiple surgical procedures and are critically ill, requiring careful attention to nutritional support, ventilatory management, and surveillance for sepsis. The care of these patients requires a multidisciplinary approach involving personnel in internal medicine, gastroenterology, radiology, surgery, anesthesiology, and nursing. Pancreatitis does not respect the boundaries of class, race, creed, gender, or traditional specialty interests; only by using a collegial approach, which shares expertise in a multidisciplinary fashion, is it possible to optimize patient care and salvage critically ill patients with this deadly disease.
一般来说，治疗胰腺炎的最佳方法是尽早发现其存在，积极对患者进行复苏，并采用营养和药物治疗以避免并发症。然而，由于创伤或药物治疗失败，一些患者会出现需要手术干预的并发症（如出血性或坏死性胰腺炎、脓肿、假性囊肿或瘘管）。需要专业的外科判断来决定哪些患者需要手术、何时进行手术以及进行何种手术。这些患者中的许多人需要多次手术，病情危重，需要密切关注营养支持、通气管理以及败血症监测。对这些患者的护理需要多学科方法，涉及内科、胃肠病学、放射学、外科、麻醉学和护理等领域的人员。胰腺炎不受阶层、种族、信仰、性别或传统专业兴趣的限制；只有通过采用多学科方式共享专业知识的合作方法，才有可能优化患者护理并挽救患有这种致命疾病的重症患者。
