Escalating strategies of surgical intervention for infected pancreatic necrosis
10.3760/cma.j.cn115610-20230330-00140
- VernacularTitle:感染性胰腺坏死外科干预升级策略
- Author:
Bei SUN
1
;
Zhibo LI
;
Tianqi LU
;
Guanqun LI
Author Information
1. 哈尔滨医科大学附属第一医院胰胆外科 肝脾外科教育部重点实验室，哈尔滨 150001
- Keywords:
Pancreatic diseases;
Acute necrotizing pancreatitis;
Infected pancreatic necrosis;
Surgery;
Treatment
- From:
Chinese Journal of Digestive Surgery
2023;22(5):593-598
- CountryChina
- Language:Chinese
-
Abstract:
The step-up approach is the most important modality in the treatment of infected pancreatic necrosis (IPN) and has been recommended by several national and international guidelines. Screening patients with low success rates of percutaneous drainage for timely treatment using the step-up approach and selecting appropriate escalation approach based on IPN staging are expected to improve the overall cure rate of IPN. The open debridement in the step-up approach should be carried out under reasonable indications and timing. When the patient's overall condition is poor and the condition of disease is complex, it is not necessary to adhere to a fixed treatment mode and choose a leapfrogging treatment strategy in a timely manner after thorough evaluation.When following the step-up approach in the treatment of IPN, endoscopic and surgical interventions are advocated in parallel, and escalating and leapfrogging strategies are promoted to establish an integrated, disease-centric, multidisciplinary treatment platform, with the aim of improving clinical prognosis. The authors review relevant literature and combine with team's treatment experience to explore the escalating strategies of surgical intervention for IPN, with a view to further improving the overall cure rate of IPN patients.
