中国实用外科杂志

中国实用外科杂志 ›› 2023, Vol. 43 ›› Issue (07): 816-818.DOI: 10.19538/j.cjps.issn1005-2208.2023.07.21

• 讲座 • 上一篇    下一篇

胰腺切除术后胰腺炎预防及诊治策略

曹    锋，卢炯地，李    非   

  1. 首都医科大学宣武医院普通外科 首都医科大学急性胰腺炎临床诊疗与研究中心，北京100053
  • 出版日期:2023-07-01 发布日期:2023-07-23

  • Online:2023-07-01 Published:2023-07-23

摘要： 胰腺手术后急性胰腺炎（PPAP）是胰腺切除术后的独立并发症。国际胰腺外科研究小组在2022年制定了PPAP的定义和分级标准，由临床、生化和影像三部分组成，并根据PPAP的严重程度将其分为A、B、C 3个等级。 PPAP将导致胰腺切除术后病人的住院时间延长、并发症发生率和病死率增高。术后血清生物学标记物（C反应蛋白、白细胞介素6、淀粉酶及脂肪酶等）水平可预测PPAP的发生。胰腺质地软、主胰管直径≤3 mm、残胰血供差是发生PPAP的独立危险因素。PPAP治疗尚无统一规范，目前以使用生长抑素类似物和充分引流为主。对出现胰腺坏死、器官衰竭、严重腹腔感染的PPAP病人，可行挽救性全胰腺切除术。

关键词: 急性胰腺炎, 术后并发症, 胰十二指肠切除术

Abstract: Prevention and treatment strategies for pancreatitis after pancreatectomy        CAO Feng，LU Jiong-di, LI Fei. Department of General Surgery, Xuanwu Hospital & Clinical Center for Acute Pancreatitis, Capital Medical University, Beijing 100053, China
Corresponding auhtor: LI Fei, E-mail: feili36@ccmu.edu.cn
Abstract    Postpancreatectomyacute pancreatitis(PPAP) is considered as an independent complication after pancreatectomy, and it may affect the incidence and prognosis of other complications in patients undergoing pancreatic resection. In 2022, the International Pancreatic Surgery Research Group (ISGPS) developed a definition and classification system of PPAP, consisting of clinical, biochemical, and imaging components. This study summarized previous studies on the definition, prediction and prevention of PPAP, in order to optimize the treatment strategy of PPAP and improve the prognosis of patients.  

Key words: acute pancreatitis, postoperative complication, pancreaticoduodenectomy