急性胆源性胰腺炎普外科治疗的分层策略与干预时机选择

Stratification Strategy and Intervention Opportunity Selection of General Surgical Treatment for Acute Biliary Pancreatitis

摘要: 急性胆源性胰腺炎(ABP)是急性胰腺炎最常见的类型，在我国占半数以上，发病与胆道结石梗阻共同通道密切相关。普外科在ABP治疗中扮演核心角色，治疗策略已从早期急诊手术演变为依据疾病严重程度分层、多学科协作、精准把握干预时机与方式的微创化和个体化模式。本文结合国内外指南及循证证据，对ABP的普外科治疗策略进行综述，重点阐述胆囊切除术时机、内镜逆行胰胆管造影的应用指征、重症ABP的外科处理及多学科协作。

Abstract: Acute biliary pancreatitis (ABP) is the most common type of acute pancreatitis, accounting for more than half of cases in China, and its pathogenesis is closely associated with biliary stone obstruction at the common channel. General surgery plays a central role in the management of ABP. The therapeutic strategy has evolved from early emergency surgery to a minimally invasive and individualized model that is stratified according to disease severity, delivered through multidisciplinary collaboration, and precisely timed in terms of intervention indication and modality. This article reviews the general surgical treatment strategies for ABP based on domestic and international guidelines and evidence‑based data, with a focus on the timing of cholecystectomy, indications for endoscopic retrograde cholangiopancreatography, surgical management of severe ABP, and multidisciplinary teamwork.