The clinical practice and related reflections of staged step-up approach in the treatment of patients with severe acute pancreatitis.
- Author:
Bei SUN
1
,
2
;
Email: SUNBEI70@TOM.COM.
;
Liang JI
3
Author Information
1. Department of Pancreatic and Biliary Surgery, the First Affiliated Hospital of Harbin Medical University, Harbin 150001, China
2. Email: sunbei70@tom.com.
3. Department of Pancreatic and Biliary Surgery, the First Affiliated Hospital of Harbin Medical University, Harbin 150001, China.
- Publication Type:Journal Article
- MeSH:
Acute Disease;
Debridement;
Drainage;
Endoscopy;
Humans;
Pancreatitis;
surgery;
Retroperitoneal Space;
Treatment Outcome
- From:
Chinese Journal of Surgery
2015;53(9):653-656
- CountryChina
- Language:Chinese
-
Abstract:
Both new insights in the pathophysiology of severe acute pancreatitis (SAP) and upspringing related evidence-based supports prompt the staged step-up approach, which stress emphasis on minimal invasiveness and damage control, to be accepted and advocated by the majority of guidelines. For documented or suspected patients with infected pancreatic necrosis, an imaging-guided percutaneous catheter drainage or an endoscopic transluminal drainage should be initially performed followed by, if necessary, a minimal access retroperitoneal necrosectomy, or a video-assisted retroperitoneal debridement, or an endoscopic transluminal necrosectomy, or an even an open access necrosectomy. The outstanding performance of staged step-up approach in patients with SAP has been justified from both a clinical and a health economic point of view, meanwhile, there are some issues remained to be further elucidated and optimized.
