Abstract:

From "step-up" to "step-jump": Leapfrog therapy of infected necrotizing pancreatitis        MIAO Yi, HUANG Dong-ya, LI Qiang, et al. Department of Pancreas Center, First Affiliated Hospital with Nanjing Medical University, Nanjing 210029，China
Corresponding author：MIAO Yi.  E-mail：miaoyi@njmu.edu.cn
Abstract    "Step up" approach is one of the important treatment approaches of contemporary infected necrotizing pancreatitis (INP), which benefits some patients. However, due to the complexity and frequent changes of INP, the same method should not be used in the treatment of INP, but targeted treatment should be adopted according to the specific situation of patients. For some patients who are bound to need surgical intervention, surgeons should leapfrog the traditional "step-up" sequential treatment procedure, and adopt the "step-jump" strategy to intervene patients in advance. Surgeons should classify the actual situation of patients and construct clinical prediction model of different intervention methods of INP, so as to carry out more accurate classification treatment. The highly integrated multidisciplinary team overcomes the limitations of specialized treatment. The future development direction of INP treatment is to establish a disease-centered multidisciplinary integrated technology platform.

Key words: infected necrotizing pancreatitis, multidisciplinary team, severe acute pancreatitis；necrotizing pancreatitis

摘要： “step-up”升阶梯模式是当代感染坏死性胰腺炎（INP）的重要治疗模式之一，部分病人因此获益。然而，INP病情复杂多变决定了其治疗不可千篇一律采用同一种方法，而是需要根据病人具体情况，采用有针对性的治疗方案。对部分势必需要外科干预的病人应跨越传统的“step-up”序贯治疗程序，宜采取“step-jump”跨阶梯治疗策略对病人提前外科干预。应对病人的实际情况进行分型，构建INP不同干预方式的临床预测模型，从而进行更精准的分类治疗。高度一体化的多学科综合治疗协作组诊疗模式克服了专科治疗的局限，建立以疾病为中心的多学科一体化技术平台将是未来INP治疗的发展方向。

关键词: 感染坏死性胰腺炎, 多学科综合治疗协作组, 重症急性胰腺炎, 坏死性胰腺炎