随着微创治疗理念的发展,微创技术在急性胆源性胰腺炎(ABP)中的应用也逐渐得到青睐和广泛推广,但其在干预指征、方法及时机等方面仍有一定争议。本综述旨在对ABP的微创治疗,包括内镜治疗、微创手术、穿刺引流等手段的选择进行总结,为临床实践及应用提供参考。ABP病情多变,应在保守治疗期间尽快完善相关检查,早期诊断并评估病情严重程度,针对不同病情采取相应的微创治疗,制定个体化方案,在恰当时机选择合适的微创方法或综合措施进行治疗。With the development of minimally invasive treatment concept, the application of minimally invasive techniques in acute biliary pancreatitis (ABP) has gradually been favored and widely promoted, but its intervention indications, methods and timing are still controversial. The purpose of this review is to summarize the selection of minimally invasive treatment for ABP, including endoscopic therapy, minimally invasive surgery, puncture drainage and other means, so as to provide reference for clinical practice and application. The condition of ABP is changeable, and relevant examinations should be improved as soon as possible during conservative treatment, early diagnosis and evaluation of the severity of the condition, corresponding minimally invasive treatment for different conditions, individualized plans, and appropriate minimally invasive methods or comprehensive measures should be selected at the right time for treatment.
慢性胰腺炎是多种因素导致胰腺组织结构和功能出现不可逆的持续性损害的病理状态,其主要特点是胰腺组织的炎症反应及纤维化,可引起慢性疼痛、胰腺内外分泌功能障碍、生活质量下降以及预期寿命缩短。近年来,该病的发病率呈上升趋势。目前慢性胰腺炎诊断的金标准仍存在争议,诊断时应优先选择影像学检查(CT或MRI),只有在CT或MRI无法明确诊断或需要进行内镜介入治疗时,才建议使用内镜超声技术。慢性胰腺炎的管理强调多学科协作,包括评估病因、症状控制、处理并发症等。如果患者的症状难以控制或存在恶变的可能,应及时采取进一步治疗措施。Chronic pancreatitis is a pathological condition caused by various factors, leading to irreversible and persistent structural and functional damage to the pancreatic tissue. Its main characteristics include pancreatic inflammation and fibrosis, which can result in chronic pain, endocrine and exocrine pancreatic dysfunction, reduced quality of life, and shortened life expectancy. In recent years, the incidence of this disease has been on the rise. Currently, there is still controversy regarding the gold standard for diagnosing chronic pancreatitis. Imaging examinations (CT or MRI) should be the preferred diagnostic method, and endoscopic ultrasound is only recommended when CT or MRI cannot provide a definitive diagnosis or when endoscopic intervention is required. The management of chronic pancreatitis emphasizes a multidisciplinary approach, including the assessment of etiology, symptom control, and management of complications. If patients' symptoms are difficult to control or there is a risk of malignant transformation, further therapeutic measures should be promptly implemented.
