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, 曹鋒. 中國急性胰腺炎診治指南 (2021). 中國實用外科雜志, 2021, 41(7): 739-746.
7.	Lepp?niemi 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.	Bezmarevi? 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, 孫備. 感染性胰腺壞死分型的初探與外科干預策略的再思考. 中華外科雜志, 2021, 59(7): 601-607.
18.	Maurer LR, Fagenholz PJ. Contemporary surgical management of pancreatic necrosis. JAMA Surg, 2023, 158(1): 81-88.
19.	Car?an? ET, Gheonea DI, S?ftoiu A. Advances in endoscopic ultrasound imaging of colorectal diseases. World J Gastroenterol, 2016, 22(5): 1756-1766.
20.	中華醫學會消化病學分會胰腺疾病學組, 《中華胰腺病雜志》編委會, 《中華消化雜志》編委會. 中國急性胰腺炎診治指南 (2019年, 沈陽). 臨床肝膽病雜志, 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.	尚東, 張慶凱, 張桂信. 多鏡聯合治療復雜膽道結石的難點與要點. 中華肝臟外科手術學電子雜志, 2018, 7(3): 177-180.
27.	李軍祥, 陳誩, 唐文富. 急性胰腺炎中西醫結合診療共識意見 (2017年). 中國中西醫結合消化雜志, 2017, 25(12): 901-909.
28.	中國中西醫結合學會普通外科專業委員會. 重癥急性胰腺炎中西醫結合診治指南 (2014年, 天津). 臨床肝膽病雜志, 2015, 31(3): 327-331.
29.	中華中醫藥學會脾胃病分會. 急性胰腺炎中醫診療專家共識意見 (2017). 臨床肝膽病雜志, 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, 曹鋒. 中國急性胰腺炎診治指南 (2021). 中國實用外科雜志, 2021, 41(7): 739-746.
7. Lepp?niemi 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. Bezmarevi? 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, 孫備. 感染性胰腺壞死分型的初探與外科干預策略的再思考. 中華外科雜志, 2021, 59(7): 601-607.
18. Maurer LR, Fagenholz PJ. Contemporary surgical management of pancreatic necrosis. JAMA Surg, 2023, 158(1): 81-88.
19. Car?an? ET, Gheonea DI, S?ftoiu A. Advances in endoscopic ultrasound imaging of colorectal diseases. World J Gastroenterol, 2016, 22(5): 1756-1766.
20. 中華醫學會消化病學分會胰腺疾病學組, 《中華胰腺病雜志》編委會, 《中華消化雜志》編委會. 中國急性胰腺炎診治指南 (2019年, 沈陽). 臨床肝膽病雜志, 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. 尚東, 張慶凱, 張桂信. 多鏡聯合治療復雜膽道結石的難點與要點. 中華肝臟外科手術學電子雜志, 2018, 7(3): 177-180.
27. 李軍祥, 陳誩, 唐文富. 急性胰腺炎中西醫結合診療共識意見 (2017年). 中國中西醫結合消化雜志, 2017, 25(12): 901-909.
28. 中國中西醫結合學會普通外科專業委員會. 重癥急性胰腺炎中西醫結合診治指南 (2014年, 天津). 臨床肝膽病雜志, 2015, 31(3): 327-331.
29. 中華中醫藥學會脾胃病分會. 急性胰腺炎中醫診療專家共識意見 (2017). 臨床肝膽病雜志, 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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