[Rediscussion of the individualized surgical intervention and timing for necrotizing pancreatitis].

Abstract

Necrotizing pancreatitis is a complicated disease with multiple clinical outcomes. Although it s hard to select appropriate treatment strategies, it s still an important branch in improving the curative effect. The pathology and outcome of local complications of necrotizing pancreatitis show great diversity and individualized differences in different patients and stages of pathogenesis. Currently, a variety of treatment strategies for local complications of necrotizing pancreatitis, including minimally invasive treatment and laparotomy, can be selected. Removal of infected and necrotic tissues and adequate drainage of peripancreatic effusion are the basic principles. In clinical practice, minimally invasive and laparotomy strategies should be dialectically implemented according to the specific conditions and indications of patients. And we should avoid unilaterally emphasizing one method over the other or invariably using one method to deal with all patients conditions. Clinical practice has proved that the choice of operation time is more decisive than the selection of debridement method to the success of treatment for local complications of necrotizing pancreatitis. As long as the operation time is appropriate, any debridement method can achieve good results. Therefore, we should avoid the overemphasis on debridement method, and ignore the significance of operation time for patients. In clinical practice, we are supposed to attach importance to the timing of intervention and selection of intervention methods according to the specific conditions of patients.