The Diagnosis and Treatment of Local Complications of Acute Necrotizing Pancreatitis in China: A National Survey

Gastroenterology research and practice

article

Xiaowu Dong¹  Wenjian Mao¹  Lu Ke²  Lin Gao²  Jing Zhou²  Bo Ye²  Gang Li²  Anthony Phillips³  Zhihui Tong²  John Windsor³  Weiqin Li¹ 

[1] Center of Severe Acute Pancreatitis (CSAP), Department of Critical Care Medicine, Jinling Clinical Medical College of Nanjing Medical University;Center of Severe Acute Pancreatitis (CSAP), Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University;Surgical and Translational Research Centre, Faculty of Medical and Health Sciences, University of Auckland;Applied Surgery and Metabolism Laboratory, School of Biological Sciences, University of Auckland;HBP/Upper GI Unit, Department of General Surgery, Auckland City Hospital;National Institute of Healthcare Data Science at Nanjing University

DOI  :  10.1155/2021/6611149

来源: Hindawi Publishing Corporation

【 摘 要 】

Background . The optimal management strategy in acute necrotizing pancreatitis (ANP) is debated, and compliance with current guidelines in China is not known. In this study, we performed a national survey on this topic in China. Methods . An online questionnaire about the diagnosis and treatment of local complications of ANP was distributed through a national collaborative network. The local and systemic complications were defined according to the Revised Atlanta Classification. Results . There were 321 survey respondents from the 394 who opened the link (response rate 81%) from 208 hospitals located in 30/34 provinces across China. There was a lack of consensus in terms of early diagnosis of infected pancreatic necrosis (IPN) as the respondents chose to depend on clinical symptoms (70/321, 22%), organ failure (82/321, 26%), imaging changes (84/321, 26%), and fine needle aspiration (51/321, 16%), respectively. A “step-up” approach has been widely adopted in patients with IPN (294/321, 92%). The decision for initial intervention (without confirmed/suspected infection) was based on clinical condition, CT imaging, or laboratory indicators for most respondents (229/321, 71%). Conclusion . While the “step-up” approach has been widely adopted, there is still significant variation in regard to the diagnosis of infection, the best timing for drainage, and the indications for early intervention.

【 授权许可】

CC BY