Progress in diagnosis and treatment of acute biliary pancreatitis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

FENG Lei , ZHANG Yi , XU Dequan , ZHOU Haoxin ,  HOU Limin

Department of Emergency Surgery, The First Affiliated Hospital, Harbin Medical University, Harbin 150001, P. R. China;

Corresponding author：

HOU Limin, Email: houlimin1969@163.com

Keywords：

acute biliary pancreatitis; diagnosis; treatment

DOI：

10.7507/1007-9424.201810067

Video：

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Objective To summarize new progress in diagnosis and treatment of acute biliary pancreatitis at present.Method The related literatures on the acute biliary pancreatitis in recent years were searched and reviewed.Results The acute biliary pancreatitis was a common acute abdomen in the surgery. The biliary stone was the main cause of the disease. The disease was acute, rapid, and has a high mortality rate. It was not difficult to make a diagnosis by relying on the imaging and laboratory tests. The active non-surgical treatment and surgical intervention were the key to a clear diagnosis, but the appropriate surgical timing should be chosen.Conclusions For acute biliary pancreatitis, active surgical intervention based on non-surgical treatment is focus of treatment. Reasonable choice of surgical methods and timely surgical intervention can effectively prevent progression of disease, reduce mortality rate, and maximize patients’ benefits.

Citation： FENG Lei, ZHANG Yi, XU Dequan, ZHOU Haoxin, HOU Limin. Progress in diagnosis and treatment of acute biliary pancreatitis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(4): 508-512. doi: 10.7507/1007-9424.201810067 Copy

1.	Pang Y, Kartsonaki C, Turnbull I, et al. Metabolic and lifestyle risk factors for acute pancreatitis in Chinese adults: A prospective cohort study of 0.5 million people. PLoS Med, 2018, 15(8): e1002618.
2.	Wang GJ, Gao CF, Wei D, et al. Acute pancreatitis: etiology and common pathogenesis. World J Gastroenterol, 2009, 15(12): 1427-1430.
3.	Shah AP, Mourad MM, Bramhall SR. Acute pancreatitis: current perspectives on diagnosis and management. J Inflamm Res, 2018, 11: 77-85.
4.	Chung AY, Duke MC. Acute biliary disease. Surg Clin North Am, 2018, 98(5): 877-894.
5.	中华医学会外科学分会胰腺外科学组. 急性胰腺炎诊治指南(2014). 中华肝胆外科杂志, 2015, 21(1): 1-4.
6.	Mandalia A, Wamsteker EJ, DiMagno M. Recent advances in understanding and managing acute pancreatitis. Version 2. F1000Res, 2018, 7: F1000 Faculty Rev-959.
7.	da Costa DW, Schepers NJ, Römkens TE, et al. Endoscopic sphincterotomy and cholecystectomy in acute biliary pancreatitis. Surgeon, 2016, 14(2): 99-108.
8.	Cremer A, Arvanitakis M. Diagnosis and management of bile stone disease and its complications. Minerva Gastroenterol Dietol, 2016, 62(1): 103-129.
9.	Anderloni A, Repici A. Role and timing of endoscopy in acute biliary pancreatitis. World J Gastroenterol, 2015, 21(40): 11205-11208.
10.	Somani P, Sunkara T, Sharma M. Role of endoscopic ultrasound in idiopathic pancreatitis. World J Gastroenterol, 2017, 23(38): 6952-6961.
11.	孙力祺, 金震东. 内镜新技术在胆胰疾病诊断中的应用. 临床肝胆病杂志, 2018, 34(3): 467-472.
12.	Keil R. The benefit of urgent endoscopic retrograde cholangiopancreatography for the therapy of acute pancreatitis. Vnitr Lek, 2016, 62(7-8): 588-591.
13.	于源泉, 李江涛. 内镜技术在急性胆源性胰腺炎诊治中的合理应用. 中国实用外科杂志, 2017, 37(8): 923-924.
14.	Xu J, Cui Y, Tian X. Early continuous veno-venous hemofiltration is effective in decreasing intra-abdominal pressure and serum interleukin-8 level in severe acute pancreatitis patients with abdominal compartment syndrome. Blood Purif, 2017, 44(4): 276-282.
15.	Al-Mansour MR, Fung EC, Jones EL, et al. Surgeon-performed endoscopic retrograde cholangiopancreatography. Outcomes of 2 392 procedures at two tertiary care centers. Surg Endosc, 2018, 32(6): 2871-2876.
16.	Tohda G, Ohtani M, Dochin M. Efficacy and safety of emergency endoscopic retrograde cholangiopancreatography for acute cholangitis in the elderly. World J Gastroenterol, 2016, 22(37): 8382-8388.
17.	Luthra AK, Patel K, Li F, et al. Endoscopic intervention and cholecystectomy in pregnant women with acute biliary pancreatitis decreases early readmissions. Gastrointest Endosc, 2018 Nov 29. pii: S0016-5107(18)33334-0.
18.	Schepers NJ, Bakker OJ, Besselink MG, et al. Early biliary decompression versus conservative treatment in acute biliary pancreatitis (APEC trial): study protocol for a randomized controlled trial. Trials, 2016, 17: 5.
19.	孙传涛, 李胜保, 童强, 等. 早期内镜治疗重症急性胰腺炎并发腹腔内高压/腹腔间隔室综合征的效果研究. 中国内镜杂志, 2018, 24(2): 63-67.
20.	唐悦锋, 徐杨荣, 廖国庆. 早期内镜治疗在重症急性胆源性胰腺炎治疗中的作用. 中国普通外科杂志, 2010, 19(7): 801-804.
21.	Mador BD, Panton ON, Hameed SM. Early versus delayed cholecystectomy following endoscopic sphincterotomy for mild biliary pancreatitis. Surg Endosc, 2014, 28(12): 3337-3342.
22.	Kuo VC, Tarnasky PR. Endoscopic management of acute biliary pancreatitis. Gastrointest Endosc Clin N Am, 2013, 23(4): 749-768.
23.	Aksoy F, Demiral G, Ekinci Ö. Can the timing of laparoscopic cholecystectomy after biliary pancreatitis change the conversion rate to open surgery? Asian J Surg, 2018, 41(4): 307-312.
24.	Abellán Morcillo I, Qurashi K, Abrisqueta Carrión J, et al. Laparoscopic common bile duct exploration. Lessons learned after 200 cases. Cir Esp, 2014, 92(5): 341-347.
25.	Ricci C, Pagano N, Taffurelli G, et al. Comparison of efficacy and safety of 4 combinations of laparoscopic and intraoperative techniques for management of gallstone disease with biliary duct calculi: a systematic review and network meta-analysis. JAMA Surg, 2018, 153(7): e181167.
26.	仝宝元, 梁琰. 89例急性胆源性胰腺炎治疗体会. 中国普外基础与临床杂志, 2011, 18(4): 432-434.
27.	贺炜, 耿小平. 重症急性胰腺炎的微创渐进式诊疗现状. 中国普外基础与临床杂志, 2016, 23(9): 1136-1141.
28.	孙昀, 耿小平. 急性胆源性胰腺炎诊断与治疗进展. 中国实用外科杂志, 2010, 30(8): 707-710.
29.	Yokoe M, Hata J, Takada T, et al. Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholecystitis (with videos). J Hepatobiliary Pancreat Sci, 2018, 25(1): 41-54.
30.	Arvanitakis M, Dumonceau JM, Albert J, et al. Endoscopic management of acute necrotizing pancreatitis: European Society of Gastrointestinal Endoscopy (ESGE) evidence-based multidisciplinary guidelines. Endoscopy, 2018, 50(5): 524-546.
31.	Oría A, Cimmino D, Ocampo C, et al. Early endoscopic intervention versus early conservative management in patients with acute gallstone pancreatitis and biliopancreatic obstruction: a randomized clinical trial. Ann Surg, 2007, 245(1): 10-17.
32.	Chen P, Hu B, Wang C, et al. Pilot study of urgent endoscopic intervention without fluoroscopy on patients with severe acute biliary pancreatitis in the intensive care unit. Pancreas, 2010, 39(3): 398-402.
33.	Vege SS, DiMagno MJ, Forsmark CE, et al. Initial medical treatment of acute pancreatitis: American gastroenterological association institute technical review. Gastroenterology, 2018, 154(4): 1103-1139.
34.	Lee HS, Chung MJ, Park JY, et al. Urgent endoscopic retrograde cholangiopancreatography is not superior to early ERCP in acute biliary pancreatitis with biliary obstruction without cholangitis. PLoS One, 2018, 13(2): e0190835.
35.	Ahmed M. Acute cholangitis—an update. World J Gastrointest Pathophysiol, 2018, 9(1): 1-7.
36.	张维新, 王纪春, 郭海华. 急性胆源性胰腺炎合并急性胆管炎的治疗策略. 基层医学论坛, 2010, 14(26): 785-786.
37.	Fiocca F, Santagati A, Ceci V, et al. ERCP and acute pancreatitis. Eur Rev Med Pharmacol Sci, 2002, 6(1): 13-17.
38.	Yokoe M, Takada T, Mayumi T, et al. Japanese guidelines for the management of acute pancreatitis: Japanese Guidelines 2015. J Hepatobiliary Pancreat Sci, 2015, 22(6): 405-432.
39.	A-Cienfuegos J, Rotellar F. Cholecystectomy in mild acute biliary pancreatitis: the sooner; the better. Rev Esp Enferm Dig, 2016, 108(3): 115-116.
40.	Borreca D, Bona A, Bellomo MP, et al. Timing of cholecystectomy in acute biliary pancreatitis: is it still reasonable to wait? Minerva Chir, 2016, 71(1): 31-37.
41.	Dedemadi G, Nikolopoulos M, Kalaitzopoulos I, et al. Management of patients after recovering from acute severe biliary pancreatitis. World J Gastroenterol, 2016, 22(34): 7708-7717.
42.	张凌, 卢山, 陆慧敏, 等. 重症急性胰腺炎术后腹腔出血的危险因素分析及诊治经验. 中国普外基础与临床杂志, 2018, 25(5): 565-571.

1. Pang Y, Kartsonaki C, Turnbull I, et al. Metabolic and lifestyle risk factors for acute pancreatitis in Chinese adults: A prospective cohort study of 0.5 million people. PLoS Med, 2018, 15(8): e1002618.
2. Wang GJ, Gao CF, Wei D, et al. Acute pancreatitis: etiology and common pathogenesis. World J Gastroenterol, 2009, 15(12): 1427-1430.
3. Shah AP, Mourad MM, Bramhall SR. Acute pancreatitis: current perspectives on diagnosis and management. J Inflamm Res, 2018, 11: 77-85.
4. Chung AY, Duke MC. Acute biliary disease. Surg Clin North Am, 2018, 98(5): 877-894.
5. 中华医学会外科学分会胰腺外科学组. 急性胰腺炎诊治指南(2014). 中华肝胆外科杂志, 2015, 21(1): 1-4.
6. Mandalia A, Wamsteker EJ, DiMagno M. Recent advances in understanding and managing acute pancreatitis. Version 2. F1000Res, 2018, 7: F1000 Faculty Rev-959.
7. da Costa DW, Schepers NJ, Römkens TE, et al. Endoscopic sphincterotomy and cholecystectomy in acute biliary pancreatitis. Surgeon, 2016, 14(2): 99-108.
8. Cremer A, Arvanitakis M. Diagnosis and management of bile stone disease and its complications. Minerva Gastroenterol Dietol, 2016, 62(1): 103-129.
9. Anderloni A, Repici A. Role and timing of endoscopy in acute biliary pancreatitis. World J Gastroenterol, 2015, 21(40): 11205-11208.
10. Somani P, Sunkara T, Sharma M. Role of endoscopic ultrasound in idiopathic pancreatitis. World J Gastroenterol, 2017, 23(38): 6952-6961.
11. 孙力祺, 金震东. 内镜新技术在胆胰疾病诊断中的应用. 临床肝胆病杂志, 2018, 34(3): 467-472.
12. Keil R. The benefit of urgent endoscopic retrograde cholangiopancreatography for the therapy of acute pancreatitis. Vnitr Lek, 2016, 62(7-8): 588-591.
13. 于源泉, 李江涛. 内镜技术在急性胆源性胰腺炎诊治中的合理应用. 中国实用外科杂志, 2017, 37(8): 923-924.
14. Xu J, Cui Y, Tian X. Early continuous veno-venous hemofiltration is effective in decreasing intra-abdominal pressure and serum interleukin-8 level in severe acute pancreatitis patients with abdominal compartment syndrome. Blood Purif, 2017, 44(4): 276-282.
15. Al-Mansour MR, Fung EC, Jones EL, et al. Surgeon-performed endoscopic retrograde cholangiopancreatography. Outcomes of 2 392 procedures at two tertiary care centers. Surg Endosc, 2018, 32(6): 2871-2876.
16. Tohda G, Ohtani M, Dochin M. Efficacy and safety of emergency endoscopic retrograde cholangiopancreatography for acute cholangitis in the elderly. World J Gastroenterol, 2016, 22(37): 8382-8388.
17. Luthra AK, Patel K, Li F, et al. Endoscopic intervention and cholecystectomy in pregnant women with acute biliary pancreatitis decreases early readmissions. Gastrointest Endosc, 2018 Nov 29. pii: S0016-5107(18)33334-0.
18. Schepers NJ, Bakker OJ, Besselink MG, et al. Early biliary decompression versus conservative treatment in acute biliary pancreatitis (APEC trial): study protocol for a randomized controlled trial. Trials, 2016, 17: 5.
19. 孙传涛, 李胜保, 童强, 等. 早期内镜治疗重症急性胰腺炎并发腹腔内高压/腹腔间隔室综合征的效果研究. 中国内镜杂志, 2018, 24(2): 63-67.
20. 唐悦锋, 徐杨荣, 廖国庆. 早期内镜治疗在重症急性胆源性胰腺炎治疗中的作用. 中国普通外科杂志, 2010, 19(7): 801-804.
21. Mador BD, Panton ON, Hameed SM. Early versus delayed cholecystectomy following endoscopic sphincterotomy for mild biliary pancreatitis. Surg Endosc, 2014, 28(12): 3337-3342.
22. Kuo VC, Tarnasky PR. Endoscopic management of acute biliary pancreatitis. Gastrointest Endosc Clin N Am, 2013, 23(4): 749-768.
23. Aksoy F, Demiral G, Ekinci Ö. Can the timing of laparoscopic cholecystectomy after biliary pancreatitis change the conversion rate to open surgery? Asian J Surg, 2018, 41(4): 307-312.
24. Abellán Morcillo I, Qurashi K, Abrisqueta Carrión J, et al. Laparoscopic common bile duct exploration. Lessons learned after 200 cases. Cir Esp, 2014, 92(5): 341-347.
25. Ricci C, Pagano N, Taffurelli G, et al. Comparison of efficacy and safety of 4 combinations of laparoscopic and intraoperative techniques for management of gallstone disease with biliary duct calculi: a systematic review and network meta-analysis. JAMA Surg, 2018, 153(7): e181167.
26. 仝宝元, 梁琰. 89例急性胆源性胰腺炎治疗体会. 中国普外基础与临床杂志, 2011, 18(4): 432-434.
27. 贺炜, 耿小平. 重症急性胰腺炎的微创渐进式诊疗现状. 中国普外基础与临床杂志, 2016, 23(9): 1136-1141.
28. 孙昀, 耿小平. 急性胆源性胰腺炎诊断与治疗进展. 中国实用外科杂志, 2010, 30(8): 707-710.
29. Yokoe M, Hata J, Takada T, et al. Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholecystitis (with videos). J Hepatobiliary Pancreat Sci, 2018, 25(1): 41-54.
30. Arvanitakis M, Dumonceau JM, Albert J, et al. Endoscopic management of acute necrotizing pancreatitis: European Society of Gastrointestinal Endoscopy (ESGE) evidence-based multidisciplinary guidelines. Endoscopy, 2018, 50(5): 524-546.
31. Oría A, Cimmino D, Ocampo C, et al. Early endoscopic intervention versus early conservative management in patients with acute gallstone pancreatitis and biliopancreatic obstruction: a randomized clinical trial. Ann Surg, 2007, 245(1): 10-17.
32. Chen P, Hu B, Wang C, et al. Pilot study of urgent endoscopic intervention without fluoroscopy on patients with severe acute biliary pancreatitis in the intensive care unit. Pancreas, 2010, 39(3): 398-402.
33. Vege SS, DiMagno MJ, Forsmark CE, et al. Initial medical treatment of acute pancreatitis: American gastroenterological association institute technical review. Gastroenterology, 2018, 154(4): 1103-1139.
34. Lee HS, Chung MJ, Park JY, et al. Urgent endoscopic retrograde cholangiopancreatography is not superior to early ERCP in acute biliary pancreatitis with biliary obstruction without cholangitis. PLoS One, 2018, 13(2): e0190835.
35. Ahmed M. Acute cholangitis—an update. World J Gastrointest Pathophysiol, 2018, 9(1): 1-7.
36. 张维新, 王纪春, 郭海华. 急性胆源性胰腺炎合并急性胆管炎的治疗策略. 基层医学论坛, 2010, 14(26): 785-786.
37. Fiocca F, Santagati A, Ceci V, et al. ERCP and acute pancreatitis. Eur Rev Med Pharmacol Sci, 2002, 6(1): 13-17.
38. Yokoe M, Takada T, Mayumi T, et al. Japanese guidelines for the management of acute pancreatitis: Japanese Guidelines 2015. J Hepatobiliary Pancreat Sci, 2015, 22(6): 405-432.
39. A-Cienfuegos J, Rotellar F. Cholecystectomy in mild acute biliary pancreatitis: the sooner; the better. Rev Esp Enferm Dig, 2016, 108(3): 115-116.
40. Borreca D, Bona A, Bellomo MP, et al. Timing of cholecystectomy in acute biliary pancreatitis: is it still reasonable to wait? Minerva Chir, 2016, 71(1): 31-37.
41. Dedemadi G, Nikolopoulos M, Kalaitzopoulos I, et al. Management of patients after recovering from acute severe biliary pancreatitis. World J Gastroenterol, 2016, 22(34): 7708-7717.
42. 张凌, 卢山, 陆慧敏, 等. 重症急性胰腺炎术后腹腔出血的危险因素分析及诊治经验. 中国普外基础与临床杂志, 2018, 25(5): 565-571.

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