Progress in minimally invasive treatment of acute pancreatitis with integrated traditional Chinese and Western medicine_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WAN Xing ^1,2 , MA Jingyuan ^1,2 , LIU Jifeng ¹ , ZHANG Qingkai ¹ , ZHANG Guixin ^1,2 ,  LI Shuang ¹ ,  SHANG Dong ^1,2

1. Department of General Surgery, First Affiliated Hospital of Dalian Medical University, Dalian 116011, P. R. China;
2. Institute of Integrative Medicine, Dalian Medical University, Dalian 116011, P. R. China;

Corresponding author：

LI Shuang, Email: lis10dmu@163.com; SHANG Dong, Email: shangdong@dmu.edu.cn

Keywords：

acute pancreatitis; minimally invasive combination of traditional Chinese and Western medicine; SELECT concept; multiple endoscopic combinations

DOI：

10.7507/1007-9424.202310042

Video：

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Acute pancreatitis is a common surgical acute abdomen in clinical practice. With the development of minimally invasive technology, more and more treatment methods are being applied to acute pancreatitis, especially for severe acute pancreatitis and acute biliary pancreatitis. At present, the efficacy of integrated traditional Chinese and Western medicine in the treatment of acute pancreatitis has been widely recognized. In terms of minimally invasive diagnosis and treatment of acute pancreatitis, the “SELECT” concept of integrated traditional Chinese and Western medicine minimally invasive diagnosis and treatment has emerged. Based on the severity and etiology of acute pancreatitis, the optimal combination of multiple endoscope (Spyglass, encoscopic retrograde cholangiopancreatography, laparoscopy, endoscopic ultrasound, choledochoscopy) is selected, and combined with traditional Chinese medicine treatment. With a patient-centered approach, we have achieved minimally invasive, individualized, and precise treatment of acute pancreatitis through the integration of traditional Chinese and Western medicine.

Citation： WAN Xing, MA Jingyuan, LIU Jifeng, ZHANG Qingkai, ZHANG Guixin, LI Shuang, SHANG Dong. Progress in minimally invasive treatment of acute pancreatitis with integrated traditional Chinese and Western medicine. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2024, 31(2): 140-145. doi: 10.7507/1007-9424.202310042 Copy

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2.	Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis–2012: revision of the Atlanta classification and definitions by international consensus. Gut, 2013, 62(1): 102-111.
3.	Szatmary P, Grammatikopoulos T, Cai W, et al. Acute pancreatitis: diagnosis and treatment. Drugs, 2022, 82(12): 1251-1276.
4.	Lee PJ, Papachristou GI. New insights into acute pancreatitis. Nat Rev Gastroenterol Hepatol, 2019, 16(8): 479-496.
5.	Schepers NJ, Bakker OJ, Besselink MG, et al. Impact of characteristics of organ failure and infected necrosis on mortality in necrotising pancreatitis. Gut, 2019, 68(6): 1044-1051.
6.	李非, 曹锋. 中国急性胰腺炎诊治指南 (2021). 中国实用外科杂志, 2021, 41(7): 739-746.
7.	Leppäniemi A, Tolonen M, Tarasconi A, et al. 2019 WSES guidelines for the management of severe acute pancreatitis. World J Emerg Surg, 2019, 14: 27. doi: 10.1186/s13017-019-0247-0.
8.	Heckler M, Hackert T, Hu K, et al. Severe acute pancreatitis: surgical indications and treatment. Langenbecks Arch Surg, 2021, 406(3): 521-535.
9.	Bezmarević M, van Dijk SM, Voermans RP, et al. Management of (peri)pancreatic collections in acute pancreatitis. Visc Med, 2019, 35(2): 91-96.
10.	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.
11.	Jang JW, Kim MH, Oh D, et al. Factors and outcomes associated with pancreatic duct disruption in patients with acute necrotizing pancreatitis. Pancreatology, 2016, 16(6): 958-965.
12.	Baron TH, DiMaio CJ, Wang AY, et al. American Gastroenterological Association Clinical Practice Update: Management of Pancreatic Necrosis. Gastroenterology, 2020, 158(1): 67-75. e1.
13.	Yin J, Chen Z, Niu W, et al. Using a multidisciplinary team for the staged management and optimally minimally invasive treatment of severe acute pancreatitis. Biosci Trends, 2021, 15(3): 180-187.
14.	Gomatos IP, Halloran CM, Ghaneh P, et al. Outcomes from minimal access retroperitoneal and open pancreatic necrosectomy in 394 patients with necrotizing pancreatitis. Ann Surg, 2016, 263(5): 992-1001.
15.	Horvath K, Freeny P, Escallon J, et al. Safety and efficacy of video-assisted retroperitoneal debridement for infected pancreatic collections: a multicenter, prospective, single-arm phase 2 study. Arch Surg, 2010, 145(9): 817-825.
16.	van Brunschot S, van Grinsven J, van Santvoort HC, et al. Endoscopic or surgical step-up approach for infected necrotising pancreatitis: a multicentre randomised trial. Lancet, 2018, 391(10115): 51-58.
17.	隋宇航, 孙备. 感染性胰腺坏死分型的初探与外科干预策略的再思考. 中华外科杂志, 2021, 59(7): 601-607.
18.	Maurer LR, Fagenholz PJ. Contemporary surgical management of pancreatic necrosis. JAMA Surg, 2023, 158(1): 81-88.
19.	Cârțână ET, Gheonea DI, Săftoiu A. Advances in endoscopic ultrasound imaging of colorectal diseases. World J Gastroenterol, 2016, 22(5): 1756-1766.
20.	中华医学会消化病学分会胰腺疾病学组, 《中华胰腺病杂志》编委会, 《中华消化杂志》编委会. 中国急性胰腺炎诊治指南 (2019年, 沈阳). 临床肝胆病杂志, 2019, 35(12): 2706-2711.
21.	Tenner S, Baillie J, DeWitt J, et al. American College of Gastroenterology guideline: management of acute pancreatitis. Am J Gastroenterol, 2013, 108(9): 1400-1415.
22.	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. doi: 10.1371/journal.pone.0190835.
23.	Schepers NJ, Hallensleben NDL, Besselink MG, et al. Urgent endoscopic retrograde cholangiopancreatography with sphincterotomy versus conservative treatment in predicted severe acute gallstone pancreatitis (APEC): a multicentre randomised controlled trial. Lancet, 2020, 396(10245): 167-176.
24.	Gurusamy KS, Davidson C, Gluud C, et al. Early versus delayed laparoscopic cholecystectomy for people with acute cholecystitis. Cochrane Database Syst Rev, 2013, 6: CD005440.
25.	Working Group IAP/APA Acute Pancreatitis Guidelines. IAP/APA evidence-based guidelines for the management of acute pancreatitis. Pancreatology, 2013, 13(4 Suppl 2): e1-e15.
26.	尚东, 张庆凯, 张桂信. 多镜联合治疗复杂胆道结石的难点与要点. 中华肝脏外科手术学电子杂志, 2018, 7(3): 177-180.
27.	李军祥, 陈誩, 唐文富. 急性胰腺炎中西医结合诊疗共识意见 (2017年). 中国中西医结合消化杂志, 2017, 25(12): 901-909.
28.	中国中西医结合学会普通外科专业委员会. 重症急性胰腺炎中西医结合诊治指南 (2014年, 天津). 临床肝胆病杂志, 2015, 31(3): 327-331.
29.	中华中医药学会脾胃病分会. 急性胰腺炎中医诊疗专家共识意见 (2017). 临床肝胆病杂志, 2017, 33(11): 2052-2057.

1. Boxhoorn L, Voermans RP, Bouwense SA, et al. Acute pancreatitis. Lancet, 2020, 396(10252): 726-734.
2. Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis–2012: revision of the Atlanta classification and definitions by international consensus. Gut, 2013, 62(1): 102-111.
3. Szatmary P, Grammatikopoulos T, Cai W, et al. Acute pancreatitis: diagnosis and treatment. Drugs, 2022, 82(12): 1251-1276.
4. Lee PJ, Papachristou GI. New insights into acute pancreatitis. Nat Rev Gastroenterol Hepatol, 2019, 16(8): 479-496.
5. Schepers NJ, Bakker OJ, Besselink MG, et al. Impact of characteristics of organ failure and infected necrosis on mortality in necrotising pancreatitis. Gut, 2019, 68(6): 1044-1051.
6. 李非, 曹锋. 中国急性胰腺炎诊治指南 (2021). 中国实用外科杂志, 2021, 41(7): 739-746.
7. Leppäniemi A, Tolonen M, Tarasconi A, et al. 2019 WSES guidelines for the management of severe acute pancreatitis. World J Emerg Surg, 2019, 14: 27. doi: 10.1186/s13017-019-0247-0.
8. Heckler M, Hackert T, Hu K, et al. Severe acute pancreatitis: surgical indications and treatment. Langenbecks Arch Surg, 2021, 406(3): 521-535.
9. Bezmarević M, van Dijk SM, Voermans RP, et al. Management of (peri)pancreatic collections in acute pancreatitis. Visc Med, 2019, 35(2): 91-96.
10. 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.
11. Jang JW, Kim MH, Oh D, et al. Factors and outcomes associated with pancreatic duct disruption in patients with acute necrotizing pancreatitis. Pancreatology, 2016, 16(6): 958-965.
12. Baron TH, DiMaio CJ, Wang AY, et al. American Gastroenterological Association Clinical Practice Update: Management of Pancreatic Necrosis. Gastroenterology, 2020, 158(1): 67-75. e1.
13. Yin J, Chen Z, Niu W, et al. Using a multidisciplinary team for the staged management and optimally minimally invasive treatment of severe acute pancreatitis. Biosci Trends, 2021, 15(3): 180-187.
14. Gomatos IP, Halloran CM, Ghaneh P, et al. Outcomes from minimal access retroperitoneal and open pancreatic necrosectomy in 394 patients with necrotizing pancreatitis. Ann Surg, 2016, 263(5): 992-1001.
15. Horvath K, Freeny P, Escallon J, et al. Safety and efficacy of video-assisted retroperitoneal debridement for infected pancreatic collections: a multicenter, prospective, single-arm phase 2 study. Arch Surg, 2010, 145(9): 817-825.
16. van Brunschot S, van Grinsven J, van Santvoort HC, et al. Endoscopic or surgical step-up approach for infected necrotising pancreatitis: a multicentre randomised trial. Lancet, 2018, 391(10115): 51-58.
17. 隋宇航, 孙备. 感染性胰腺坏死分型的初探与外科干预策略的再思考. 中华外科杂志, 2021, 59(7): 601-607.
18. Maurer LR, Fagenholz PJ. Contemporary surgical management of pancreatic necrosis. JAMA Surg, 2023, 158(1): 81-88.
19. Cârțână ET, Gheonea DI, Săftoiu A. Advances in endoscopic ultrasound imaging of colorectal diseases. World J Gastroenterol, 2016, 22(5): 1756-1766.
20. 中华医学会消化病学分会胰腺疾病学组, 《中华胰腺病杂志》编委会, 《中华消化杂志》编委会. 中国急性胰腺炎诊治指南 (2019年, 沈阳). 临床肝胆病杂志, 2019, 35(12): 2706-2711.
21. Tenner S, Baillie J, DeWitt J, et al. American College of Gastroenterology guideline: management of acute pancreatitis. Am J Gastroenterol, 2013, 108(9): 1400-1415.
22. 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. doi: 10.1371/journal.pone.0190835.
23. Schepers NJ, Hallensleben NDL, Besselink MG, et al. Urgent endoscopic retrograde cholangiopancreatography with sphincterotomy versus conservative treatment in predicted severe acute gallstone pancreatitis (APEC): a multicentre randomised controlled trial. Lancet, 2020, 396(10245): 167-176.
24. Gurusamy KS, Davidson C, Gluud C, et al. Early versus delayed laparoscopic cholecystectomy for people with acute cholecystitis. Cochrane Database Syst Rev, 2013, 6: CD005440.
25. Working Group IAP/APA Acute Pancreatitis Guidelines. IAP/APA evidence-based guidelines for the management of acute pancreatitis. Pancreatology, 2013, 13(4 Suppl 2): e1-e15.
26. 尚东, 张庆凯, 张桂信. 多镜联合治疗复杂胆道结石的难点与要点. 中华肝脏外科手术学电子杂志, 2018, 7(3): 177-180.
27. 李军祥, 陈誩, 唐文富. 急性胰腺炎中西医结合诊疗共识意见 (2017年). 中国中西医结合消化杂志, 2017, 25(12): 901-909.
28. 中国中西医结合学会普通外科专业委员会. 重症急性胰腺炎中西医结合诊治指南 (2014年, 天津). 临床肝胆病杂志, 2015, 31(3): 327-331.
29. 中华中医药学会脾胃病分会. 急性胰腺炎中医诊疗专家共识意见 (2017). 临床肝胆病杂志, 2017, 33(11): 2052-2057.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Progress in minimally invasive treatment of acute pancreatitis with integrated traditional Chinese and Western medicine

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