Imaging features, when and how to perform minimally invasive intervention in infected pancreatic necrosis patients
10.19538/j.cjps.issn1005-2208.2019.06.13
- Author:
Kun GAO
1
;
Zhi-hui TONG
1
;
Wei-qin LI
1
Author Information
1. Department of General Surgery,Jinling Hospital,Jinling Clinical Medical College of Nanjing Medical University,General Hospital of Eastern Military Command of PLA Nanjing210002, China
- Publication Type:Journal Article
- Keywords:
acute pancreatitis;
infected pancreatic necrosis;
step-up approach
- From:
Chinese Journal of Practical Surgery
2019;39(06):575-580
- CountryChina
- Language:Chinese
-
Abstract:
Recently,with the further understanding of infected pancreatic necrosis(IPN),pancreatologists have reached consensuses on that the presence of gas on CT imaging could be the golden standard diagnosis for IPN,the intervention timing for IPN should be delayed to four weeks later,and the step-up approach acts as the first standard treatment strategy for IPN.Whereas in clinical practice,there are substantial new challenges awaiting our solutions,for instance,the lack of accurate and specific diagnostic criteria for IPN without typical gas sign on CT imaging,whether the intervention of wall-off necrosis(WON)which got infected prematurely should be delayed to four weeks later?What's more,whether the endoscopy centered step-up approach is superior to the surgical step-up approach?Is it time to abandon open surgery in IPN management?If not,when should we switch to open necrosectomy?All of these questions are still full of controversies.
