Abstract: The progress and evolution about the surgical treatment of biliary pancreatitis in domestic and international guidelines        ZHANG Tai-ping, QIU Jiang-dong. Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
Corresponding author: ZHANG Tai-ping, E-mail: tpingzhang@yahoo.com
Abstract    Biliary pancreatitis is the main type of acute pancreatitis in China, with rapid changes in patients’ condition and high mortality rates. Although dramatic progress has been achieved in the management of btiliary pancreatitis via intensive care procedures and endoscopy, surgery still plays an important role in the treatment of regional complications and biliary diseases. In recent years, with the development of the concept and techniques of minimally invasive surgery, the surgical indication, time and strategy for the treatment of biliary pancreatitis have changed a lot in guidelines. The surgical management of biliary pancreatitis is moving into a minimally invasive, staged and multi-disciplinary age. Clinicians should consider various factors, follow the principles of individualization and multi-disciplinary, and should not stick to a single treatment mode when making treatment plans based on relevant domestic and foreign guidelines. At the same time, the prognosis of patients can be further improved by taking into account the local conditions of pancreas and primary biliary tract diseases.

Key words: biliary pancreatitis, guidelines, surgical treatment

摘要： 胆源性胰腺炎是我国急性胰腺炎的主要类型，病情进展快，病死率高，是临床处理较为棘手的急腹症。尽管重症医学综合治疗措施及消化内镜技术在胆源性胰腺炎的治疗中取得了长足的进步，但外科手段在胰腺局部并发症及胆道原发疾病的处理中仍有不可替代的作用。近年来，随着微创技术的发展和治疗理念的普及，国内外指南中关于胆源性胰腺炎的外科干预指征、时机与方式的选择有较大改变。胆源性胰腺炎的外科治疗向微创化、阶段化及多学科方向转变。临床医师在基于国内外相关指南制定治疗方案的同时，宜综合考虑多方面因素，遵循个体化、多学科原则，不可拘泥于单一的治疗方式。同时，在兼顾胰腺局部情况与原发胆道疾病的情况下，进一步提升病人预后。

关键词: 胆源性胰腺炎, 指南, 外科治疗