胰十二指肠切除术后急性胰腺炎的现状及发展

Current Status and Development of Acute Pancreatitis after Pancreaticoduodenectomy

目的:总结胰十二指肠切除术后急性胰腺炎的研究现状及发展,旨在探讨胰十二指肠切除术后急性胰腺炎是增加术后并发症发生率及严重程度的预测因子,以及为预防胰十二指肠切除术后急性胰腺炎提供思路。方法:检索胰十二指肠切除术后急性胰腺炎的相关文献,并作一综述。结果:目前国内外均有使用血清淀粉酶、血清脂肪酶、C反应蛋白及引流液淀粉酶等指标早期预测胰瘘、腹腔感染、腹腔出血、胃排空延迟、胰腺坏死等胰十二指肠切除术后并发症的研究,但术后胰腺炎对术后并发症影响的研究较少。结论:术后急性胰腺炎是一个单独的并发症,具有单独的临床结果,部分术后胰腺炎在术后早期表现为炎症过程,但有时也会导致坏死性胰腺炎或其他更严重的临床结局,提前预防并尽早地诊断术后胰腺炎以防增加术后并发症发生率及严重程度具有一定的临床意义及研究价值。

Objective: To summarize the research status and development of acute pancreatitis after pancre-aticoduodenectomy, and to explore the role of acute pancreatitis after pancreaticoduodenectomy as a predictor of increasing incidence and severity of postoperative complications, and to provide ideas for prevention of acute pancreatitis after pancreaticoduodenectomy. Methods: The literature on acute pancreatitis after pancreaticoduodenectomy was searched and reviewed. Results: At present, there are studies at home and abroad that use serum amylase, serum lipase, C-reactive protein and drainage fluid amylase to predict early complications after pancreaticoduodenectomy such as pan-creatic fistula, abdominal infection, abdominal hemorrhage, delayed gastric emptie, pancreatic ne-crosis, etc., but there are few studies on the effect of postoperative pancreatitis on postoperative complications. Conclusion: Postoperative acute pancreatitis is a separate complication with a sepa-rate clinical outcome. Part of postoperative pancreatitis is characterized by an inflammatory pro-cess in the early postoperative period, but sometimes it can also lead to necrotizing pancreatitis or other more serious clinical outcomes. It is of certain clinical significance and research value to pre-vent and diagnose postoperative pancreatitis as early as possible to avoid increasing the incidence and severity of postoperative complications.