Pathogenesis of Acute Pancreatitis During Pregnancy and The Standardization of Diagnosis and Treatment_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 QUANSheng-wei , PANGXin-ya ,  GAOFeng

Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150000, Heilongjiang Prouvince, China;

Corresponding?author：

GAOFeng, Email: 2601693448@qq.com

Keywords：

Pregnancy; Acute pancreatitis; Pathogenesis; Diagnosis; Treatment

DOI：

10.7507/1007-9424.20150011

Video：

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Objective To explore the pathogenesis of acute pancreatitis during pregnancy, differential diagnosis, and standardized treatment. Methods The related literatures at home and abroad in recent years were reviewed, and the progress of pathogenesis and treatment of acute pancreatitis during pregnancy were summarized. Results The common cause of acute pancreatitis during pregnancy include biliary system diseases, hyperlipidemia, hyperparathyroidism, the direct effect of pregnancy on the pancreas, etc. According to the different pathogenic factors of acute pancreatitis during pregnancy, the laparoscopic cholecystectomy (LC), endoscopic retrograde cholangiopancreatography (ERCP), low-fat diet combined with Omega-3 fatty acids, parathyroid adenoma resection, or terminal pregnancy could be use. Conclusion Acute pancreatitis during pregnancy is dangerous, the cause, general condition of patients, and the growth of fetus should be give full consideration, and the diagnosis and treatment are standardized.

Citation： QUANSheng-wei, PANGXin-ya, GAOFeng. Pathogenesis of Acute Pancreatitis During Pregnancy and The Standardization of Diagnosis and Treatment. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(1): 40-44. doi: 10.7507/1007-9424.20150011 Copy

1.	Pitchumoni CS, Yegneswaran B. Acute pancreatltis in pregnancy. World J Gastrcenterol, 2009, 15(45):5641-5646.
2.	Ramin KD, Ramin SM, Richey SI, et al. Acute pancreatitis in pregnancy. Am J Obestet Gynecol, 1995, 173(1):187-191.
3.	Working Group IAP/APA Acute Panereatitis Guidelines. IAP/APA evidence-based guidelines for the management of acute pancreatitis. Pancreatology, 2013, 13(4 Suppl 2):el-e15.
4.	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.
5.	中華醫學會消化病學分會胰腺疾病學組.中國急性胰腺炎診治指南(草案).中華內科雜志, 2004, 43(3):236-238.
6.	He C, Zhang L, Shi W, et al. Coupled plasma filtration adsorption combined with continuous veno-venous hemofiltration treatment in patients with severe acute pancreatitis. Clin Gastroenterol, 2013, 47(1):62-68.
7.	Badja N, Troche G, Zzaao JF, et al. Acute pancreatitis and preeclampsia-eclampsia:a case report. Am J Obstet Gynecol, 1997, 176:707-709.
8.	Knobell R, Castilho LN, Passini R, et al. Hyperlipidemic pancreatitis in a primigravida adolescent. Dig Dis Sci, 1998, 43(5):943-944.
9.	Block P, Kelly TR. Managerment of gallstone pancreatitis during prengency and the postpartum period. Surg Gynecol Obsytet, 1989, 168(5):426-428.
10.	Turhan AN, G?nen? M, Kapan S, et al. Acute biliary pancreatitis related with pregnancy:a 5-year single center experience. Ulus Travma Acil Cerrahi Derg, 2010, 16(2):160-164.
11.	李兆申.對急性胰腺炎分類的重新認識.中華消化雜志, 2013, 33(11):724-726.
12.	陳平, 袁耀宗.中華消化雜志, 急性胰腺炎的病因與分類, 2013, 33(11):727-729.
13.	Sadr-Azodi O, Orsini N, Andrén-Sandberg ?. Abdominal and total adiposity and the risk of acute pancreatitis:a population based prospective cohort study. American Journal of Gastroenterology, 2013, 108(1):133-139.
14.	Balthazar EJ, Robinson DL, Megibow AJ, et al. Acute pancreatitis:value of CT in establishing prognosis. Radiology, 1990, 174(2):331-336.
15.	Tang S, Rodriguez E, Singh S, et al. Acute pancreatitis during pregnancy. Clin Gastroenterol Hepatol, 2010, 8(1):85-90.
16.	Srivastava G, Rahman N, Elsandabesee D, et al.Hyperlipidaemic pancreatitis in pregnancy. J Obstet Gynaccol, 2010, 30(1):59-60.
17.	谷麗冬, 杜宏娟.重癥胰腺炎并發癥的防治.中華醫學研究雜志, 2007, 23(9):51-53.
18.	Mounzer R, Langmead CJ, Wu BU, et al. Comparison of existing clinical scoring systems to predict persistent organ failure in patients with acute pancreatitis. Gastroenterology, 2012, 142(7):1476-1482.
19.	高宇, 汪偉, 黎燕, 等.妊娠合并急性胰腺炎13例分析.吉林醫學, 2014, 35(15): 3281-3282.
20.	Petrov MS. Management of acute biliary pancreatitis during pregnancy:past and present. Am J Surg, 2009, 198(1):154-155.
21.	丁薏, 陳義森.妊娠期急性脂肪肝26例死亡分析.中華婦產科雜志, 1993, 31(9):558-559.
22.	秦學軍.血清淀粉酶和脂肪酶聯合測定在急性胰腺炎診斷中的意義.中國實用醫藥, 2013, 8(7):44-45.
23.	Petrov MS. Management of acute biliary pancreatitis during pregnancy:past and present. Am J Surg, 2009, 198(1):154-155.
24.	Nakai Y, Isayama H, Kogure H, et al. Risk factors for covered metallic stent migration in patients with distal malignant biliary obstruction due to pancreatic cancer. J Gastroenterol Hepatol, 2014, 29(9):1744-1749.
25.	Bani Hani MN, Bani-Hani KE, Rashdan A, et al. Safety of endoscopic retrograde cholangiopancreatography during pregnancy. ANZ J Surg, 2009, 79(1-2):23-26.
26.	杜奕奇, 湛先保, 謝沛, 等.以內科綜合治療為特色的重癥急性胰腺炎1 064例次臨床總結.中華胰腺病雜志, 2012, 12(6):366-370.
27.	Takaishi K, Miyoshi J, Matsumura T, et al. Hypertriglyceridemicacute pancreatitis during pregnancy:Prevention with diet therapy andω-3 fatty acids in the following pregnancy. Nutrition, 2009, 25(11-12):1094-1097.
28.	Krysiak R, Wilk M, Okopien B. Recurrent pancreatitis induced by hyperparathyroidism in pregnancy. Arch Gynecol Obstet, 2011, 284(3):531-534.
29.	Daas AY, Agha A, Pinkas H, et al. ERCP in pregnancy:is it safe? Gastroenterol Hepatol(N Y), 2009, 5(12):851-855.
30.	Russo-Stieglitz KE, Levine AB, Wagner BA, et al. Pregnancy outcome in patients requiring parenteral nutrition. J Matern Fetal Med, 1999, 8(4):164-167.
31.	代鳴, 鄒志梅, 周艷芬, 等.妊娠合并急性胰腺炎9例臨床診治分析.實用婦產科雜志, 2012, 28(11):969-971.
32.	王剛, 孫備, 許軍, 等.妊娠期急性胰腺炎12例臨床分析.哈爾濱醫科大學學報, 2011, 38(6):570-572.
33.	Saravana P, Blumenthal S, Anderson C, et al. Plasma exchange for dramatic gestation hyperlipidemic pancreatitis. J Clin Gastronenterol, 1996, 22(4):295-298.
34.	Baron TH, Schueler BA. Pregnancy and radiation exposure during therapeutic ERCP:time to put the baby to bed? Gastrointest Endosc, 2009, 69(4):832-834.
35.	Nanda S, Gupta A, Dora A, et al. Acute pancreatitis a rare cause of acute abdomen in pregnancy. Arch Gyncol Obstet, 2009, 279(4):577-578.
36.	Ducarme G, Maire F2, Chatel P, et al. Acute pancreatitis during pregnancy:a feview. J Perinatol, 2014, 34(2):87-94.
37.	中華醫學會消化病學會分會胰腺疾病組.中國急性胰腺炎診治指南.中華消化雜志, 2013, 4(4):217-222.

1. Pitchumoni CS, Yegneswaran B. Acute pancreatltis in pregnancy. World J Gastrcenterol, 2009, 15(45):5641-5646.
2. Ramin KD, Ramin SM, Richey SI, et al. Acute pancreatitis in pregnancy. Am J Obestet Gynecol, 1995, 173(1):187-191.
3. Working Group IAP/APA Acute Panereatitis Guidelines. IAP/APA evidence-based guidelines for the management of acute pancreatitis. Pancreatology, 2013, 13(4 Suppl 2):el-e15.
4. 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.
5. 中華醫學會消化病學分會胰腺疾病學組.中國急性胰腺炎診治指南(草案).中華內科雜志, 2004, 43(3):236-238.
6. He C, Zhang L, Shi W, et al. Coupled plasma filtration adsorption combined with continuous veno-venous hemofiltration treatment in patients with severe acute pancreatitis. Clin Gastroenterol, 2013, 47(1):62-68.
7. Badja N, Troche G, Zzaao JF, et al. Acute pancreatitis and preeclampsia-eclampsia:a case report. Am J Obstet Gynecol, 1997, 176:707-709.
8. Knobell R, Castilho LN, Passini R, et al. Hyperlipidemic pancreatitis in a primigravida adolescent. Dig Dis Sci, 1998, 43(5):943-944.
9. Block P, Kelly TR. Managerment of gallstone pancreatitis during prengency and the postpartum period. Surg Gynecol Obsytet, 1989, 168(5):426-428.
10. Turhan AN, G?nen? M, Kapan S, et al. Acute biliary pancreatitis related with pregnancy:a 5-year single center experience. Ulus Travma Acil Cerrahi Derg, 2010, 16(2):160-164.
11. 李兆申.對急性胰腺炎分類的重新認識.中華消化雜志, 2013, 33(11):724-726.
12. 陳平, 袁耀宗.中華消化雜志, 急性胰腺炎的病因與分類, 2013, 33(11):727-729.
13. Sadr-Azodi O, Orsini N, Andrén-Sandberg ?. Abdominal and total adiposity and the risk of acute pancreatitis:a population based prospective cohort study. American Journal of Gastroenterology, 2013, 108(1):133-139.
14. Balthazar EJ, Robinson DL, Megibow AJ, et al. Acute pancreatitis:value of CT in establishing prognosis. Radiology, 1990, 174(2):331-336.
15. Tang S, Rodriguez E, Singh S, et al. Acute pancreatitis during pregnancy. Clin Gastroenterol Hepatol, 2010, 8(1):85-90.
16. Srivastava G, Rahman N, Elsandabesee D, et al.Hyperlipidaemic pancreatitis in pregnancy. J Obstet Gynaccol, 2010, 30(1):59-60.
17. 谷麗冬, 杜宏娟.重癥胰腺炎并發癥的防治.中華醫學研究雜志, 2007, 23(9):51-53.
18. Mounzer R, Langmead CJ, Wu BU, et al. Comparison of existing clinical scoring systems to predict persistent organ failure in patients with acute pancreatitis. Gastroenterology, 2012, 142(7):1476-1482.
19. 高宇, 汪偉, 黎燕, 等.妊娠合并急性胰腺炎13例分析.吉林醫學, 2014, 35(15): 3281-3282.
20. Petrov MS. Management of acute biliary pancreatitis during pregnancy:past and present. Am J Surg, 2009, 198(1):154-155.
21. 丁薏, 陳義森.妊娠期急性脂肪肝26例死亡分析.中華婦產科雜志, 1993, 31(9):558-559.
22. 秦學軍.血清淀粉酶和脂肪酶聯合測定在急性胰腺炎診斷中的意義.中國實用醫藥, 2013, 8(7):44-45.
23. Petrov MS. Management of acute biliary pancreatitis during pregnancy:past and present. Am J Surg, 2009, 198(1):154-155.
24. Nakai Y, Isayama H, Kogure H, et al. Risk factors for covered metallic stent migration in patients with distal malignant biliary obstruction due to pancreatic cancer. J Gastroenterol Hepatol, 2014, 29(9):1744-1749.
25. Bani Hani MN, Bani-Hani KE, Rashdan A, et al. Safety of endoscopic retrograde cholangiopancreatography during pregnancy. ANZ J Surg, 2009, 79(1-2):23-26.
26. 杜奕奇, 湛先保, 謝沛, 等.以內科綜合治療為特色的重癥急性胰腺炎1 064例次臨床總結.中華胰腺病雜志, 2012, 12(6):366-370.
27. Takaishi K, Miyoshi J, Matsumura T, et al. Hypertriglyceridemicacute pancreatitis during pregnancy:Prevention with diet therapy andω-3 fatty acids in the following pregnancy. Nutrition, 2009, 25(11-12):1094-1097.
28. Krysiak R, Wilk M, Okopien B. Recurrent pancreatitis induced by hyperparathyroidism in pregnancy. Arch Gynecol Obstet, 2011, 284(3):531-534.
29. Daas AY, Agha A, Pinkas H, et al. ERCP in pregnancy:is it safe? Gastroenterol Hepatol(N Y), 2009, 5(12):851-855.
30. Russo-Stieglitz KE, Levine AB, Wagner BA, et al. Pregnancy outcome in patients requiring parenteral nutrition. J Matern Fetal Med, 1999, 8(4):164-167.
31. 代鳴, 鄒志梅, 周艷芬, 等.妊娠合并急性胰腺炎9例臨床診治分析.實用婦產科雜志, 2012, 28(11):969-971.
32. 王剛, 孫備, 許軍, 等.妊娠期急性胰腺炎12例臨床分析.哈爾濱醫科大學學報, 2011, 38(6):570-572.
33. Saravana P, Blumenthal S, Anderson C, et al. Plasma exchange for dramatic gestation hyperlipidemic pancreatitis. J Clin Gastronenterol, 1996, 22(4):295-298.
34. Baron TH, Schueler BA. Pregnancy and radiation exposure during therapeutic ERCP:time to put the baby to bed? Gastrointest Endosc, 2009, 69(4):832-834.
35. Nanda S, Gupta A, Dora A, et al. Acute pancreatitis a rare cause of acute abdomen in pregnancy. Arch Gyncol Obstet, 2009, 279(4):577-578.
36. Ducarme G, Maire F2, Chatel P, et al. Acute pancreatitis during pregnancy:a feview. J Perinatol, 2014, 34(2):87-94.
37. 中華醫學會消化病學會分會胰腺疾病組.中國急性胰腺炎診治指南.中華消化雜志, 2013, 4(4):217-222.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Pathogenesis of Acute Pancreatitis During Pregnancy and The Standardization of Diagnosis and Treatment

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