关键词: 急性胰腺炎, 胰腺坏死组织感染, 阶梯式引流

Abstract:

Imaging features, when and how to perform minimally invasive intervention in infected pancreatic necrosis patients        GAO Kun，TONG Zhi-hui，LI Wei-qin. Department of General Surgery，Jinling Hospital,Jinling Clinical Medical College of Nanjing Medical University，General Hospital of Eastern Military Command of PLA, Nanjing210002, China
Correspondingauthor：LI Wei-qin，E-mail：liweiqindr@vip.163.com
Abstract    Recently，with the further understanding of infected pancreatic necrosis （IPN），pancreatologists have reached consensuses on that the presence of gas on CT imaging could be the golden standard diagnosis for IPN，the intervention timing for IPN should be delayed to four weeks later，and the step-up approach acts as the first standard treatment strategy for IPN.Whereas in clinical practice，there are substantial new challenges awaiting our solutions，for instance，the lack of accurate and specific diagnostic criteria for IPN without typical gas sign on CT imaging，whether the intervention of wall-off necrosis（WON）which got infected prematurely should be delayed to four weeks later?What’s more，whether the endoscopy centered step-up approach is superior to the surgical step-up approach?Is it time to abandon open surgery in IPN management?If not，when should we switch to open necrosectomy?All of these questions are still full of controversies.

Key words: acute pancreatitis, infected pancreatic necrosis, step-up approach