中国实用外科杂志2025，Vol.45Issue(3)：284-289,6.DOI:10.19538/j.cjps.issn1005-2208.2025.03.09
重症急性胰腺炎继发肠瘘的外科治疗策略
Surgical management strategies for secondary intestinal fistula in severe acute pancreatitis
摘要
Abstract
Intestinal fistula,a formidable complication in the late stage of severe acute pancreatitis(SAP),significantly elevates mortality through mechanisms including intra-abdominal infection induction,exacerbation of homeostatic imbalances,and increased nutritional risk.Its pathogenesis is multifactorial,involving mechanical compression/enzymatic erosion by peripancreatic necrotic tissues,intestinal ischemia and iatrogenic injury from invasive interventions.Early diagnosis requires a heightened clinical awareness and the judicious use of diagnostic modalities,including computed tomography(CT),fistulography,and endoscopy,to delineate the anatomical location of the fistula.Surgical management adheres to a staged therapeutic paradigm:during the conservative treatment phase,infection source control remains the cornerstone,supplemented by enteral nutrition,organ function support,and other adjunctive measures to promote spontaneous fistula closure;in the definitive surgical phase,the therapeutic approach is dictated by the anatomical location of the fistula,with conservativemanagement prioritized for upper gastrointestinal fistulas,such as those involving the stomach and duodenum,and more aggressive surgical intervention for colonic fistulas.关键词
重症急性胰腺炎/肠瘘/腹腔感染/外科治疗Key words
severe acute pancreatitis/intestinal fistula/ab-dominal infection/surgical management分类
医药卫生引用本文复制引用
黄骞,孙冉..重症急性胰腺炎继发肠瘘的外科治疗策略[J].中国实用外科杂志,2025,45(3):284-289,6.基金项目
National Natural Science Foundation of China(General Program,No.82070579) 国家自然科学基金面上项目(No.82070579) （General Program,No.82070579）
