急性胰腺炎尤其重症急性胰腺炎（severe acute pancreatitis，SAP）仍是临床凶险的腹部急症之一，后者通常伴有胰腺和胰周组织的坏死和（或）器官功能衰竭，其病死率达10%～30%。在重症急性胰腺炎诊治的若干领域，如抗生素与生长抑素及其类似物的应用、胆源性胰腺炎中的干预时机和方式、SAP合并胰腺及胰周感染的诊断以及手术干预时机、手术方式等仍存在争议。

Difficulties and disputes in the diagnosis and treatment of severe acute pancreatitis        MIAO Yi. Center for Pancreatic Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Abstract    Acute pancreatitis（AP）, especially severe acute pancreatitis（SAP）, is an abdominal emergency with dismal prognosis. With necrosis of pancreatic and parapancreatic tissue, and/or organ failures, SAP is associated with a mortality rate around 10%～30%. Controversies remains in several aspects of the diagnosis and treatment for SAP, such as prophylactic antibiotics, application of somatostatin analogues, timing and type of intervention in biliary pancreatitis, diagnosis criteria, timing of intervention and surgical procedure for infected necrosis in SAP.