中国实用外科杂志2024，Vol.44Issue(5)：516-520,5.DOI:10.19538/j.cjps.issn1005-2208.2024.05.06
升阶梯时代对重症急性胰腺炎外科干预的再认识
Further understanding of surgical intervention for severe acute pancreatitis in the era of step-up approach
摘要
Abstract
In the past decade or so,the step-up approach has become the mainstream surgical intervention model for severe acute pancreatitis(SAP).However,the complexity and variability condition of SAP,coupled with the rapid development of minimally invasive concepts and technologies,make it worthwhile for us to deeply consider how to maximize the benefits of surgical intervention for patients in the context of step-up approach.The establishment of subtypes for infectious pancreatic necrosis(IPN)has important clinical significance,which means that the treatment of different types of IPN cannot be limited to a single strategy.In some cases,traditional intervention models can be broken and a leapfrog intervention model can be adopted as a supplement and improvement to the step-up approach.The multidisciplinary tream(MDT)model runs through the entire process of individualized treatment in SAP,surgeons still play an irreplaceable role in the personalized comprehensive treatment of SAP.At present,we still need to develop personalized,precise,and minimally invasive intervention plans based on the specific situation of patients,disciplines,and the technical characteristics of doctors.Open debridement,as an important component of the step-up approach,should be carried out in a planned manner with reasonable indications and timing,and should not be neglected.In the era of stepwise treatment,it is necessary to follow the strategy of switching between progressive and leapfrog interventions as needed,emphasizing both surgical and endoscopic intervention methods,and establishing an efficient and unified MDT diagnosis and treatment platform,to further improve the overall cure rate of SAP.关键词
重症急性胰腺炎/升阶梯治疗/感染性胰腺坏死/多学科协作治疗/外科干预Key words
severe acute pancreatitis/step-up approach/infected pancreatic necrosis/multidisciplinary tream/surgical intervention分类
医药卫生引用本文复制引用
王刚,徐德全,周昊昕..升阶梯时代对重症急性胰腺炎外科干预的再认识[J].中国实用外科杂志,2024,44(5):516-520,5.基金项目
国家自然科学基金项目(No.82370651,No.82070657) （No.82370651,No.82070657）
