关键词: 重症急性胰腺炎, 感染性胰腺坏死, 外科干预, 液体复苏, 经皮穿刺置管引流

Abstract: Difficulties and countermeasures in the management of severe acute pancreatitis        SUN Bei, ZHANG Can. Department of Pancreatic and Biliary Surgery, the First Affiliated Hospital of Harbin Medical University; Key Laboratory of Hepatosplenic Surgery, Ministry of Education, Harbin 150001, China
Corresponding author: SUN Bei, E-mail: sunbei70@tom.com
Abstract    In recent years, with the development of minimally invasive and endoscopic technology, the treatment concept of Severe acute pancreatitis (SAP) is constantly updated. The “step-up approach” has become the mainstream treatment mode of SAP and has significantly improved its cure rate. Although treatment concepts and techniques are increasingly updated, there are still some challenges and controversies in the treatment of SAP, such as the principle of fluid resuscitation, the management of abdominal compartment syndrome (ACS), the timing and mode of surgical intervention for infected pancreatic necrosis (IPN), the advantages and disadvantages of endoscopic and surgical debridement, and the necessity of open debridement. All the above problems  need to be validated by further high-quality clinical studies. Multidisciplinary team is crucial, and establishing standardized pancreatic disease centers can benefit more SAP patients.

Key words: severe acute pancreatitis, infected pancreatic necrosis, surgical intervention, fluid resuscitation, percutaneous catheter drainage