Advancement on the surgical management for infectious necrosis associated with acute pancreatitis

VernacularTitle:急性胰腺炎感染性坏死的外科处理进展
Author: Zhe WANG ; Fei LI
Keywords: Acute pancreatitis; Infectious necrosis; Surgical management
From: Chinese Journal of Hepatobiliary Surgery 2017;23(1):67-70
CountryChina
Language:Chinese
Abstract: Infectious necrosis is one of severe local complications caused by acute pancreatitis,and the mortality rate was reported to be up to 10％～ 20％.Traditional open surgical debridement used to be the sole option for this disease.Nevertheless,this approach is associated with poor outcome.Currently,conservative treatment and minimally invasive procedures are more favorable.The treatment for infectious necrosis caused by acute pancreatitis can be summarized as 3D,representing delay,drain,debride.The patients usually receive initial treatment in ICU division,and surgical intervention is then delayed.Percutaneous drainage can be firstly performed in the early course of the disease,followed by necrotic tissue debridement with laparoscopic or video-assisted retroperitoneal procedures.Open surgical debridement is now rarely used,which is merely performed for certain refractory cases.The management of acute pancreatitis infected necrosis therefore is a clinical question that requires a multiple disciplinary team rather than a simply surgical disease.This paper reviewed the relevant issues.