Advances in endoscopic and surgical intervention for acute biliary pancreatitis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

GUO Xiaoyu , XIAO Fan ,  WANG Gang , SUN Bei

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

Corresponding author：

WANG Gang, Email: wgilu79@163.com

Keywords：

acute biliary pancreatitis; gastrointestinal endoscopic treatment; surgical treatment; review

DOI：

10.7507/1007-9424.201910116

Video：

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Objective To understand advances in the timing and surgical mode selection of gastrointestinal endoscopy and surgical intervention for acute biliary pancreatitis (ABP).Method The recent literatures on the timing and choice of gastrointestinal endoscopy and surgical treatments aimed at ABP were reviewed.Results For ABP patients with early cholangitis or biliary obstruction, no matter how serious, endoscopic treatment should be used to relieve obstruction and relieve symptoms. For patients only with ABP, if non-surgical treatment was not effective and patients showed symptoms such as biliary obstruction or biliary tract infection, endoscopic intervention should be considered. Most ABP patients had milder symptoms and could undergo cholecystectomy during the same hospitalization to prevent ABP recurrence after symptoms relief. Patients with severe ABP could be treated with cholecystectomy along with pancreatic necrotic tissue removal, and surgery should be performed after the disease was controlled. If the preoperative imaging examination highly suspected that there were stones in the biliary tract, biliary exploration should be performed at the same time. Laparoscopic surgery should be selected as far as possible to facilitate the postoperative recovery of the patient.Conclusions For patients with ABP, whether endoscopic or surgical treatment, the timing and surgical mode selection should follow the specific clinical situation with the “individualization” principle of the treatment. We should make the reasonable and effective policy at diagnosis and treatment according to different conditions.

Citation： GUO Xiaoyu, XIAO Fan, WANG Gang, SUN Bei. Advances in endoscopic and surgical intervention for acute biliary pancreatitis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2020, 27(7): 901-905. doi: 10.7507/1007-9424.201910116 Copy

1.	张启玲, 赵春梅. 1 例胆源性胰腺炎合并足底黑色毒瘤病人的护理. 循证护理, 2018, 4(3): 285-288.
2.	郑西, 何文华, 吕农华. 2018 年国际急性胰腺炎研究进展. 中华胰腺病杂志, 2019, 19(4): 241-244.
3.	彭淑牖, 李江涛, 刘笑雷. 急性胆源性胰腺炎的外科治疗. 肝胆外科杂志, 2007, 15(1): 7-8.
4.	Almallouhi E, Rahwan M, Kutluay E. Myoclonic status epilepticus as an initial presentation of acute biliary pancreatitis. J Neurol Sci, 2018, 392: 139-141.
5.	邹善贵, 满国军, 张相成. 急性胆源性胰腺炎的发病机制与外科手术时机探讨. 中外健康文摘, 2011, 8(14): 67-69.
6.	Papapanagiotou A, Sgourakis G, Peristeraki S, et al. Potential prediction of acute biliary pancreatitis outcome on admission. Pancreas, 2018, 47(4): 454-458.
7.	Lankisch PG, Apte M, Banks PA. Acute pancreatitis. Lancet, 2015, 386(9988): 85-96.
8.	Nøjgaard C, Becker U, Matzen P, et al. Progression from acute to chronic pancreatitis: prognostic factors, mortality, and natural course. Pancreas, 2011, 40(8): 1195-1200.
9.	Halász A, Pécsi D, Farkas N, et al. Outcomes and timing of endoscopic retrograde cholangiopancreatography for acute biliary pancreatitis. Dig Liver Dis, 2019, 51(9): 1281-1286.
10.	徐周纬, 王兴宇. 胆源性胰腺炎手术时机的选择及清胰汤应用效果分析. 肝胆外科杂志, 2019, 27(2): 116-118.
11.	孙艺昭. 急性胆源性胰腺炎病情评估及早期治疗方法的最新研究进展. 糖尿病天地, 2019, 16(9): 295, 298.
12.	Lerch MM, Saluja AK, Rünzi M, et al. Pancreatic duct obstruction triggers acute necrotizing pancreatitis in the opossum. Gastroenterology, 1993, 104(3): 853-861.
13.	秦亚飞, 王根旺, 赵李飞, 等. 急性胆源性胰腺炎的诊疗研究进展. 宁夏医科大学学报, 2019, 41(4): 427-430.
14.	Nowak A, Nowakowska-Dulawa E, Marek A, et al. Final results of the prospective, randomized, controlled study on endoscopic sphincterotomy versus conventional management in acute biliary pancreatitis. Gastroenterology, 1995, 108(4 suppl 1): A380.
15.	Coutinho LMA, Bernardo WM, Rocha RS, et al. Early endoscopic retrograde cholangiopancreatography versus conservative treatment in patients with acute biliary pancreatitis: systematic review and meta-analysis of randomized controlled trials. Pancreas, 2018, 47(4): 444-453.
16.	Fölsch UR, Nitsche R, Lüdtke R, et al. Early ERCP and papillotomy compared with conservative treatment for acute biliary pancreatitis. The German Study Group on Acute Biliary Pancreatitis. N Engl J Med, 1997, 336(4): 237-242.
17.	Lee JK, Jang DK, Kang HW, et al. Feasibility of temporary pancreatic stenting after early endoscopic retrograde cholangiopancreatography in patients with acute biliary pancreatitis. Korean J Gastroenterol, 2017, 70(5): 247-252.
18.	谭军塘. 梗阻型急性胆源性胰腺炎的治疗方式及手术时机的选择. 当代医学, 2016, 22(3): 61-62.
19.	Ridtitid W, Kulpatcharapong S, Piyachaturawat P, et al. The impact of empiric endoscopic biliary sphincterotomy on future gallstone-related complications in patients with non-severe acute biliary pancreatitis whose cholecystectomy was deferred or not performed. Surg Endosc, 2019, 33(10): 3325-3333.
20.	Robbins R, Qureshi WA. ERCP and elective cholecystectomy are safe in pregnant patients with acute biliary pancreatitis. Gastrointest Endosc, 2019, 89(6): 1178-1179.
21.	辛民志, 桑畅野. 不同手术时机治疗胆源性胰腺炎临床疗效及安全性观察. 健康必读, 2019, (5): 26-27.
22.	Kucserik LP, Márta K, Vincze Á, et al. Endoscopic sphincterotoMy for delayIng choLecystectomy in mild acute biliarY pancreatitis (EMILY study): protocol of a multicentre randomised clinical trial. BMJ Open, 2019, 9(7): e025551.
23.	Svatoň R, Kala Z, Novotný I, et al. The timing of ERCP in acute biliary pancreatitis. Rozhl Chir, 2019, 98(1): 10-13.
24.	Zakko L, Gardner TB. Endoscopic management of recurrent acute pancreatitis. Clin Gastroenterol Hepatol, 2019, 17(11): 2167-2170.
25.	中华医学会消化病学分会胰腺疾病学组, 《中华胰腺病杂志》编辑委员会, 《中华消化杂志》编辑委员会, 等. 中国急性胰腺炎诊治指南(2013, 上海). 中华胰腺病杂志, 2013, 13(2): 73-78.
26.	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.
27.	张奇, 孙备. 梗阻型胆源性胰腺炎内镜治疗时机的选择. 中国普通外科杂志, 2008, 17(3): 203-206.
28.	陈希铭, 孟宪志. 急性胆源性胰腺炎行胆囊切除术时机的选择. 腹部外科, 2019, 32(3): 230-233.
29.	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.
30.	Crockett SD, Wani S, Gardner TB, et al. American gastroenterological association institute guideline on initial management of acute pancreatitis. Gastroenterology, 2018, 154(4): 1096-1101.
31.	刘永合. 早期微创胆囊切除治疗合并急性轻型胆源性胰腺炎的胆囊结石疗效探讨. 中国中西医结合外科杂志, 2019, 25(4): 600-602.
32.	Degrate L, Bernasconi DP, Meroni P, et al. Mild acute biliary pancreatitis: the timing of cholecystectomy should not exceed index admission. Minerva Chir, 2017, 72(5): 383-390.
33.	于铁夫. 胆石性急性胰腺炎手术方式与时机选择分析. 中国保健营养, 2019, 29(6): 85.
34.	谷艳秋. 腹腔镜治疗胆原性胰腺炎的术后个体化护理措施及患者满意度评价. 中国保健营养, 2019, 29(20): 231-232.
35.	Kelly TR, Wagner DS. Gallstone pancreatitis: a prospective randomized trial of the timing of surgery. Surgery, 1988, 104(4): 600-605.
36.	王春友, 李非. 急性胰腺炎诊治指南(2014). 临床肝胆病杂志, 2015, 31(1): 17-20.
37.	汤亲青, 方茂勇. 41 例急性胆源性胰腺炎行腹腔镜胆囊切除术与胆囊切除术疗效分析和手术时机体会. 肝胆外科杂志, 2015, 23(3): 176-178.
38.	刘振宽. 浅谈应用普外科手术治疗胆源性急性胰腺炎的治疗时机及效果. 健康必读, 2019, (18): 235-236.
39.	Garg SK, Bazerbachi F, Sarvepalli S, et al. Why are we performing fewer cholecystectomies for mild acute biliary pancreatitis? Trends and predictors of cholecystectomy from the National Readmissions Database (2010-2014). Gastroenterol Rep (Oxf), 2019, 7(5): 331-337.

1. 张启玲, 赵春梅. 1 例胆源性胰腺炎合并足底黑色毒瘤病人的护理. 循证护理, 2018, 4(3): 285-288.
2. 郑西, 何文华, 吕农华. 2018 年国际急性胰腺炎研究进展. 中华胰腺病杂志, 2019, 19(4): 241-244.
3. 彭淑牖, 李江涛, 刘笑雷. 急性胆源性胰腺炎的外科治疗. 肝胆外科杂志, 2007, 15(1): 7-8.
4. Almallouhi E, Rahwan M, Kutluay E. Myoclonic status epilepticus as an initial presentation of acute biliary pancreatitis. J Neurol Sci, 2018, 392: 139-141.
5. 邹善贵, 满国军, 张相成. 急性胆源性胰腺炎的发病机制与外科手术时机探讨. 中外健康文摘, 2011, 8(14): 67-69.
6. Papapanagiotou A, Sgourakis G, Peristeraki S, et al. Potential prediction of acute biliary pancreatitis outcome on admission. Pancreas, 2018, 47(4): 454-458.
7. Lankisch PG, Apte M, Banks PA. Acute pancreatitis. Lancet, 2015, 386(9988): 85-96.
8. Nøjgaard C, Becker U, Matzen P, et al. Progression from acute to chronic pancreatitis: prognostic factors, mortality, and natural course. Pancreas, 2011, 40(8): 1195-1200.
9. Halász A, Pécsi D, Farkas N, et al. Outcomes and timing of endoscopic retrograde cholangiopancreatography for acute biliary pancreatitis. Dig Liver Dis, 2019, 51(9): 1281-1286.
10. 徐周纬, 王兴宇. 胆源性胰腺炎手术时机的选择及清胰汤应用效果分析. 肝胆外科杂志, 2019, 27(2): 116-118.
11. 孙艺昭. 急性胆源性胰腺炎病情评估及早期治疗方法的最新研究进展. 糖尿病天地, 2019, 16(9): 295, 298.
12. Lerch MM, Saluja AK, Rünzi M, et al. Pancreatic duct obstruction triggers acute necrotizing pancreatitis in the opossum. Gastroenterology, 1993, 104(3): 853-861.
13. 秦亚飞, 王根旺, 赵李飞, 等. 急性胆源性胰腺炎的诊疗研究进展. 宁夏医科大学学报, 2019, 41(4): 427-430.
14. Nowak A, Nowakowska-Dulawa E, Marek A, et al. Final results of the prospective, randomized, controlled study on endoscopic sphincterotomy versus conventional management in acute biliary pancreatitis. Gastroenterology, 1995, 108(4 suppl 1): A380.
15. Coutinho LMA, Bernardo WM, Rocha RS, et al. Early endoscopic retrograde cholangiopancreatography versus conservative treatment in patients with acute biliary pancreatitis: systematic review and meta-analysis of randomized controlled trials. Pancreas, 2018, 47(4): 444-453.
16. Fölsch UR, Nitsche R, Lüdtke R, et al. Early ERCP and papillotomy compared with conservative treatment for acute biliary pancreatitis. The German Study Group on Acute Biliary Pancreatitis. N Engl J Med, 1997, 336(4): 237-242.
17. Lee JK, Jang DK, Kang HW, et al. Feasibility of temporary pancreatic stenting after early endoscopic retrograde cholangiopancreatography in patients with acute biliary pancreatitis. Korean J Gastroenterol, 2017, 70(5): 247-252.
18. 谭军塘. 梗阻型急性胆源性胰腺炎的治疗方式及手术时机的选择. 当代医学, 2016, 22(3): 61-62.
19. Ridtitid W, Kulpatcharapong S, Piyachaturawat P, et al. The impact of empiric endoscopic biliary sphincterotomy on future gallstone-related complications in patients with non-severe acute biliary pancreatitis whose cholecystectomy was deferred or not performed. Surg Endosc, 2019, 33(10): 3325-3333.
20. Robbins R, Qureshi WA. ERCP and elective cholecystectomy are safe in pregnant patients with acute biliary pancreatitis. Gastrointest Endosc, 2019, 89(6): 1178-1179.
21. 辛民志, 桑畅野. 不同手术时机治疗胆源性胰腺炎临床疗效及安全性观察. 健康必读, 2019, (5): 26-27.
22. Kucserik LP, Márta K, Vincze Á, et al. Endoscopic sphincterotoMy for delayIng choLecystectomy in mild acute biliarY pancreatitis (EMILY study): protocol of a multicentre randomised clinical trial. BMJ Open, 2019, 9(7): e025551.
23. Svatoň R, Kala Z, Novotný I, et al. The timing of ERCP in acute biliary pancreatitis. Rozhl Chir, 2019, 98(1): 10-13.
24. Zakko L, Gardner TB. Endoscopic management of recurrent acute pancreatitis. Clin Gastroenterol Hepatol, 2019, 17(11): 2167-2170.
25. 中华医学会消化病学分会胰腺疾病学组, 《中华胰腺病杂志》编辑委员会, 《中华消化杂志》编辑委员会, 等. 中国急性胰腺炎诊治指南(2013, 上海). 中华胰腺病杂志, 2013, 13(2): 73-78.
26. 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.
27. 张奇, 孙备. 梗阻型胆源性胰腺炎内镜治疗时机的选择. 中国普通外科杂志, 2008, 17(3): 203-206.
28. 陈希铭, 孟宪志. 急性胆源性胰腺炎行胆囊切除术时机的选择. 腹部外科, 2019, 32(3): 230-233.
29. 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.
30. Crockett SD, Wani S, Gardner TB, et al. American gastroenterological association institute guideline on initial management of acute pancreatitis. Gastroenterology, 2018, 154(4): 1096-1101.
31. 刘永合. 早期微创胆囊切除治疗合并急性轻型胆源性胰腺炎的胆囊结石疗效探讨. 中国中西医结合外科杂志, 2019, 25(4): 600-602.
32. Degrate L, Bernasconi DP, Meroni P, et al. Mild acute biliary pancreatitis: the timing of cholecystectomy should not exceed index admission. Minerva Chir, 2017, 72(5): 383-390.
33. 于铁夫. 胆石性急性胰腺炎手术方式与时机选择分析. 中国保健营养, 2019, 29(6): 85.
34. 谷艳秋. 腹腔镜治疗胆原性胰腺炎的术后个体化护理措施及患者满意度评价. 中国保健营养, 2019, 29(20): 231-232.
35. Kelly TR, Wagner DS. Gallstone pancreatitis: a prospective randomized trial of the timing of surgery. Surgery, 1988, 104(4): 600-605.
36. 王春友, 李非. 急性胰腺炎诊治指南(2014). 临床肝胆病杂志, 2015, 31(1): 17-20.
37. 汤亲青, 方茂勇. 41 例急性胆源性胰腺炎行腹腔镜胆囊切除术与胆囊切除术疗效分析和手术时机体会. 肝胆外科杂志, 2015, 23(3): 176-178.
38. 刘振宽. 浅谈应用普外科手术治疗胆源性急性胰腺炎的治疗时机及效果. 健康必读, 2019, (18): 235-236.
39. Garg SK, Bazerbachi F, Sarvepalli S, et al. Why are we performing fewer cholecystectomies for mild acute biliary pancreatitis? Trends and predictors of cholecystectomy from the National Readmissions Database (2010-2014). Gastroenterol Rep (Oxf), 2019, 7(5): 331-337.

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