Abstract:
Acute pancreatitis (AP) is one of the common gastrointestinal conditions presenting as medical emergency. Clinically, the severity of AP ranges from mild to severe. Mild AP has a favorable outcome. Patients with moderately severe and severe AP, on the other hand, require hospitalization and considerable utilization of health care resources. These patients require a multidisciplinary management. Pancreatic fluid collections (PFCs) and arterial bleeding are the most important local complications of pancreatitis. PFCs may require drainage when infected or symptomatic. PFCs are drained endoscopically or percutaneously, based on the timing and the location of collection. Both the techniques are complementary, and many patients may undergo dual modality treatment. Percutaneous catheter drainage (PCD) remains the most extensively utilized method for drainage in patients with AP and necrotic PFCs. Besides being effective as a standalone treatment in a significant proportion of these patients, PCD also provides an access for percutaneous endoscopic necrosectomy and minimally invasive necrosectomy. Endovascular embolization is the mainstay of management of arterial complications in patients with AP and chronic pancreatitis. The purpose of the present guideline is to provide evidence-based recommendations for the percutaneous management of complications of pancreatitis.
摘要:
急性胰腺炎(AP)是常见的胃肠道疾病之一,表现为医疗紧急情况。临床上,AP的严重程度从轻度到重度不等.轻度AP有一个有利的结果。中度和重度AP患者,另一方面,需要住院治疗和大量利用医疗保健资源。这些患者需要多学科管理。胰腺积液(PFC)和动脉出血是胰腺炎最重要的局部并发症。当感染或有症状时,PFC可能需要引流。通过内窥镜或经皮引流PFCs,基于收集的时间和位置。这两种技术是互补的,许多患者可能接受双重模式治疗。经皮导管引流(PCD)仍然是AP和坏死性PFC患者最广泛使用的引流方法。除了在很大一部分患者中作为独立治疗有效外,PCD还为经皮内窥镜坏死切除术和微创坏死切除术提供了途径。血管内栓塞是治疗AP和慢性胰腺炎患者动脉并发症的主要手段。本指南的目的是为胰腺炎并发症的经皮治疗提供循证建议。