胰腺术后急性胰腺炎的研究进展和防治策略

doi:10.16139/j.1007-9610.2025.06.11

摘要/Abstract

摘要：

胰腺术后急性胰腺炎（PPAP）是一种胰腺术后常见的并发症，主要表现为术后早期的局部和全身炎症反应，进而引发一系列后续并发症，对病人的临床转归具有重要影响。近年来，PPAP被确立为胰腺术后的独立并发症，国际胰腺外科学组（ISGPS）亦提出其标准化定义与分级，需结合术后胰酶升高、影像学特征及临床治疗改变，受到胰腺外科领域的广泛重视。PPAP的发生与微循环障碍密切相关，临床可表现为自限性炎症，并与胰瘘发生密切相关。个别可进展为坏死性胰腺炎，或需要进一步外科干预治疗。目前其防治策略侧重于术中保护胰腺血供、围术期使用抗炎药物及对症支持治疗等，但PPAP的诊断标准、发病机制及防治体系仍需进一步研究完善。

关键词: 胰腺术后急性胰腺炎, 术后并发症, 胰十二指肠切除术, 术后胰瘘

Abstract:

Post-pancreatectomy acute pancreatitis (PPAP) is a common complication following pancreatic surgery, characterized primarily by early postoperative local and systemic inflammatory responses. These responses can trigger a series of subsequent complications, significantly impacting patient’s clinical outcomes. In recent years, PPAP has been recognized as a distinct postoperative complication, and the International Study Group of Pancreatic Surgery (ISGPS) has proposed standardized definitions and grading criteria for it, which required a combination of postoperative enzyme elevation, imaging features, and changes in clinical management. This has garnered widespread attention within the field of pancreatic surgery. The occurrence of PPAP is closely related to microcirculatory disturbances. Clinically, it can manifest as self-limiting inflammation and is closely associated with pancreatic fistula development. In some cases, it may progress to necrotizing pancreatitis, potentially requiring surgical intervention. Current prevention and management strategies focus on intraoperative preservation of pancreatic blood supply, perioperative use of anti-inflammatory medications, and symptomatic supportive care. However, the diagnostic criteria, pathogenesis, and comprehensive management framework for PPAP still require further research and refinement.

Key words: Post-pancreatectomy acute pancreatitis(PPAP), Postoperative complication, Pancreaticoduodenectomy(PD), Postoperative pancreatic fistula(POPF)

中图分类号:

R657.51

陈浩达, 沈柏用. 胰腺术后急性胰腺炎的研究进展和防治策略[J]. 外科理论与实践, 2025, 30(06): 524-528.

CHEN Haoda, SHEN Baiyong. Advances of prevention and management for post-pancreatectomy acute pancreatitis[J]. Journal of Surgery Concepts & Practice, 2025, 30(06): 524-528.

图/表 1

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