内镜下处理急性胰腺炎合并包裹性坏死亚洲共识解读.pdfVIP

内镜下处理急性胰腺炎合并包裹性坏死 亚洲共识解读 丁  玲，何文华，祝  荫 DOI：10.7504/nk2016110202    中图分类号：R576    文献标识码：A 摘 要 ： 近年来，内镜下胰腺坏死组织清除术成为优于外科手术清除术的一种处理包裹性坏死(walled-off  necrosis,WON)的治疗方法。但是，仍缺少高质量的证据，WON尚无标准治疗方法。文章对亚洲胰胆内镜干预协会 (T-CAP)成员组成的工作组制定的内镜下处理急性胰腺炎WON的亚洲共识进行解读，旨在阐明WON的诊断标 准及内镜干预治疗，以期指导WON的内镜治疗。 关键词 ：急性坏死性胰腺炎；内镜下坏死组织清除术；内镜；腔内超声检查；包裹性坏死 Interpretation of the Asian consensus statements on endoscopic management of walled-off necrosis of acute pancreatitis. DING Ling, HE Wen-hua, ZHU Yin. Department of Gastroenterology, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China Corresponding author: ZHU Yin, E-mail: zhuyin27@ Abstract: Recently, endoscopic necrosectomy has been introduced and is now preferred to surgical necrosectomy in the treatment of walled-off necrosis. However, high-quality evidence is still lacking, and there is no standard management strategy for WON. Faculty of the Tokyo Conference of Asian Pancreato-biliary Interventional Endoscopy formed the working group for this consensus statement. The Asian consensus statements on endoscopic management of walled-off necrosis aimed to clarify the diagnostic criteria for WON and the role of endoscopic interventions in its management, which will be useful for guiding endoscopic management of WON. The article summarized and interpreted the consensus briefly. Keywords: acute necrotizing pancreatitis; endoscopic necrosectomy; endoscopy; endosonography; walled-off necrosis 2012年修订的亚特兰大标准将包裹性坏死 1 流行病学 (walled-off necrosis，WON)定义为“急性胰腺炎(acute  pancreatitis, AP)起病4周后，胰腺和(或)胰周坏 1.1  急性胰腺炎(AP)患者并发WON的发生 [1] 死组织形成的成熟的包裹性积聚”，并阐明了其影 率  在大型系列研究中，坏死性胰腺炎的比例是 像学表现，