关键词: 重症急性胰腺炎, 胰腺坏死组织感染, 开放手术

Abstract: Key points of open surgery for infected pancreatic necrosis in severe acute pancreatitis        TONG Zhi-hui, LI Wei-qin, LI Jie-shou. Severe Acute Pancreatitis Treatment Center, Jinling Hospital, Medical School of Nanjing University, The Second Clinical College, Medical School of Southeast University, General Hospital of Eastern Theater Command,Jinling Clinical Medical College of Nanjing Medical University， Nanjing 210002, China
Corresponding author: LI Wei-qin, E-mail: liweiqindr@vip.163.com 
Abstract    Infected pancreatic necrosis (IPN) is a bottleneck problem in the treatment of severe acute pancreatitis (SAP) .In recent years, minimally invasive drainage has become the primary choice of treatment for IPN, but open surgery remains an important part of the new "step-up" treatment strategy. Under the new treatment strategy, not only the indications and timing of open surgery should be understood and changed, but also the operation process of open surgery should keep pace with the Times .Therefore, we summarized the key points of open -surgery under the new treatment strategy, and suggested following the three "not-to-do"s: (1) Not to involve the infracolonic compartment in the surgery; (2) No add-on surgery when doing open surgery, simplify the surgery; (3) Not to pursue complete necrosectomy during the first surgery.

Key words: severe acute pancreatitis, infected pancreatic necrosis, open surgery