Abstract: Progress and prospect of clinical research on acute pancreatitis        SUN Bei，LI Guan-qun. 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 the past 20 years, with the promulgation of several guidelines for the diagnosis and treatment of acute pancreatitis, the treatment mode and concept of acute pancreatitis have changed a lot. One of the challenges in clinical treatment is "two death peaks" in the course of severe acute pancreatitis (SAP). In early inflammatory reaction period of SAP，multidisciplinary comprehensive treatment in ICU should be strengthened，including maintenance of organ function, early fluid resuscitation，rational use of antibiotics, effective nutritional support and dealing with abdominal compartment syndrome. In later infectious complications period, surgeons play an important role to choose the indication, timing and mode of the surgical intervention. There are five characteristics present in the modern surgical intervention of SAP，which are minimal invasive, staged, multi-disciplinary, specialized and diversified. Clinicians should establish a comprehensive treatment model centered on diseases. In addition, the etiology treatment and late complications of SAP should be paid attention to prevent the disease.

Key words: severe acute pancreatitis, step-up approach, comprehensive treatment, surgical intervention

摘要： 近20年来，多个急性胰腺炎相关诊治指南相继颁布，急性胰腺炎的治疗模式及理念发生了很大变化。重症急性胰腺炎病程中的“两次死亡高峰”是临床治疗中的一大挑战。早期为炎症反应期，应进行ICU为主体的多学科综合救治，包括脏器功能维持、早期液体复苏、合理使用抗生素、营养支持及腹腔间隔室综合征的处理；后期以感染性并发症为主，外科医师对于外科干预指征、时机及方式的掌控尤为重要。现代重症急性胰腺炎的外科干预呈现微创化、阶段化、多学科化、专业化和多元化5大特点，临床医生应建立以疾病为中心的综合治疗模式。此外，还应重视重症急性胰腺炎的病因治疗及后期并发症，防患于未然。

关键词: 重症急性胰腺炎, 创伤递升式策略, 综合治疗, 外科干预