Diagnosis,severity stratification and management of adult acute pancreatitis–current evidence and controversies

作     者：Kai Siang Chan Vishal G Shelat 

作者机构：Department of General SurgeryTan Tock Seng HospitalSingapore 308433Singapore Lee Kong Chian School of MedicineNanyang Technological UniversitySingapore 308232Singapore Yong Loo Lin School of MedicineNational University of SingaporeSingapore 117597Singapore 

出 版 物：《World Journal of Gastrointestinal Surgery》 (世界胃肠外科杂志（英文版）（电子版）)

年 卷 期：2022年第14卷第11期

页      面：1179-1197页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Atlanta classification Drainage Infections Necrosectomy Pancreatitis Risk stratification 

摘      要：Acute pancreatitis(AP)is a disease spectrum ranging from mild to severe with an unpredictable natural *** of cases(80%)are mild and ***,severe AP(SAP)has a mortality risk of up to 30%.Establishing aetiology and risk stratification are essential pillars of clinical *** AP is a diagnosis of exclusion which should only be used after extended investigations fail to identify a *** of management of mild AP include pain control and management of aetiology to prevent *** SAP,patients should be resuscitated with goal-directed fluid therapy using crystalloids and admitted to critical care *** prophylactic antibiotics have limited clinical benefit and should not be given in *** able to tolerate oral intake should be given early enteral nutrition rather than nil by mouth or parenteral *** unable to tolerate per-orally,nasogastric feeding may be attempted and routine post-pyloric feeding has limited evidence of clinical *** retrograde cholangiopancreatogram should be selectively performed in patients with biliary obstruction or suspicion of acute *** step-up strategy including percutaneous retroperitoneal drainage,endoscopic debridement,or minimal-access necrosectomy are sufficient in most SAP *** should be monitored for diabetes mellitus and pseudocyst.