重症急性胰腺炎手术治疗时机及方式选择

Timing and relevant kinds of surgery of severe acute pancreatitis

重症急性胰腺炎(SAP)是涉及多学科、多系统的复杂疾病,关于其治疗方案多年来一直存有争论。随着重症医学及SAP发病机制研究的进展,治疗的天平不断偏向非手术治疗,越来越多的SAP病人通过非手术治疗获得痊愈。虽然如此,但在胆源性胰腺炎、暴发性胰腺炎等特定类型的胰腺炎及坏死感染、胰腺脓肿、胰腺假性囊肿、出血等并发症的治疗中,外科手术仍然有着无可替代的重要作用。把握手术的适应证及手术时机,选择合适的手术方式,对提高SAP的疗效有着重要的临床意义。

Severe acute pancreatitis （SAP） is a complicated disease related to multiple departments and systems. With regards to the treatment stragtegies of SAP,there are controversies all the time. With the giant advances in critical care medicine field and researches about relevant mechanism and regulation of SAP, the pendulum of treatment gradually swing to nonoperative therapy, and more and more SAP patients get cured through conservative treatments. Even so, in some special events,such as biliary pancreatitis,fulminant acute pancreatitis,pancreatic necrosis with infection, pancreatic abscess, pancreatic pseudocyst, and bleeding, surgery still plays an irreplaceable role in the treatment. It is crucial for doctors to choose the appropriate operation timing and kinds of surgery to maximize the treatment effects.