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Interventional strategies in infected necrotizing pancreatitis:Indications,timing,and outcomes

查看全文 作　　者：Birte [1]Purschke;Louisa [1]Bolm;Max Nikolaus [2]Meyer;Hiroki [3,4]Sato 高影响力作者 机构地区：[1]Department of Gastrointestinal Surgery,Massachusetts General Hospital,Boston,MA 02114,United States;[2]Department of Radiation Oncology,Massachusetts General Hospital,Boston,MA 02114,United States;[3]Department of Medicine,Asahikawa Medical University,Asahikawa 0788510,Hokkaido,Japan;[4]Department of Gastroenterology,Asahikawa Kosei Hospital,Asahikawa 0788211,Hokkaido,Japan高影响力机构 出　　处：《World Journal of Gastroenterology》索引2022年第28卷第27期,共15页高影响力期刊 基　　金：Supported by Japan Society for the Promotion of Science KAKENHI,No.19K17480 and No.21KK0283(to Sato H). 摘　　要：Acute pancreatitis(AP)is one of the most common gastrointestinal diseases and remains a life-threatening condition.Although AP resolves to restitutio ad integrum in approximately 80%of patients,it can progress to necrotizing pancreatitis(NP).NP is associated with superinfection in a third of patients,leading to an increase in mortality rate of up to 40%.Accurate and early diagnosis of NP and associated complications,as well as state-of-the-art therapy are essential to improve patient prognoses.The emerging role of endoscopy and recent trials on multidisciplinary management of NP established the“step-up approach”.This approach starts with endoscopic interventions and can be escalated to other interventional and ultimately surgical procedures if required.Studies showed that this approach decreases the incidence of new multiple-organ failure as well as the risk of interventional complications.However,the optimal interventional sequence and timing of interventional procedures remain controversial.This review aims to summarize the indications,timing,and treatment outcomes for infected NP and to provide guidance on multidisciplinary decision-making. 关 键 词：PANCREATITIS Acute necrotizing pancreatitis NECROSIS SUPERINFECTION Endoscopy Surgery
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