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随着近年来微创外科的发展,重症急性胰腺炎(SAP)的治疗方式发生了很大的变化。传统开腹坏死组织清创手术由于其并发症发生率和病死率较高,促进了内镜、影像学、腹腔镜等微创技术在SAP治疗中的应用不断增加。由于缺少前瞻性随机对照研究,难以规范SAP微创治疗模式。各种微创治疗手段也还存在一定的局限性,尚不能完全替代传统开放手术。因此,目前应加强多学科协作,动态、个体化地合理选择治疗方式。

Minimally invasive treatment of severe acute pancreatitis and therapeutic evaluation

The surgical treatment of severe acute pancreatitis(SAP) has significantly changed in the last several years with the progress of enhanced imaging techniques and minimally invasive surgery.Traditional open surgical necrosectomy for treatment of infected pancreatic necrosis is associated with high morbidity and mortality,leading to a shift toward minimally invasive endoscopic,radiologic and laparoscopic approaches.Because of absence of prospective randomized controlled trials,it is not appropriate to standardize the minimally invasive treatment for SAP.Various minimally invasive treatments have their respective limitations and can not replace the traditional open surgery completely.So the dynamic and reasonable treatments should be chosen based on multidisciplinary cooperation.