重症急性胰腺炎( severe acute pancreatitis, SAP)是一种病情险恶、并发症多、病死率较高的急腹症,占全部急性胰腺炎的10%~20%。胰腺外伤诊断困难、治疗复杂、并发症多。两者均易并发胰瘘、胰周组织感染、出血、消化道瘘等严重并发症,病死率较高。治疗时首先应对病情准确评估,选择合适的治疗方式。手术干预时机要及时、恰当,尽可能采取微创引流方式,保持引流通畅。高度重视肠内营养,维护机体自身调节功能和免疫力。同时,尽量减少抗菌药物的应用,是治疗成功的保证。%Severe acute pancreatitis ( SAP) is a dangerous and acute condition of abdomen, with a high rate of com-plications and high mortality and accounts for 10% to 20% of acute pancreatitis. Pancreatic injury is also difficult to diagnose and treat, accompanying multiple severe complications and the mortality rate is high. Both of them are prone to complicated pancreatic fistula, retroperitoneal necrosis and infections, bleeding, and digestive tract fistula, etc. The first response to the treatment of the disease is accurately assessing the patient's diagnosis and condition, selecting the appropriate treatment method and opportunity of surgical intervention. The first choice of surgical procedure is minimally invasive drainage and keeping the drainage smooth. Attaching great importance to enteral nutrition, maintaining the body's own regulatory function and immunity, and at the same time, minimizing the use of antimicrobial drugs are essential for successful treatment.
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