How to treat severe acute pancreatitis

Some people are familiar with severe acute pancreatitis, but they are still quite unfamiliar with its treatment. We all know that with the continuous development of modern medical technology, there are more and more treatments for diseases. Many times we choose a treatment method that suits us under the advice of a doctor. There are many treatments for severe acute pancreatitis.

1. Treatment targeting the cause: (1) Biliary acute pancreatitis: First, it is necessary to identify whether there is biliary obstruction. Anyone with bile duct obstruction must have the obstruction relieved promptly. The first choice is Oddi sphincter incision and stone removal and nasobiliary drainage under fiberoptic duodenoscope, or combined with laparoscopic cholecystectomy, or open surgery, including cholecystectomy and common bile duct exploration to determine whether there is obstruction at the lower end of the common bile duct. If the pancreas is significantly affected, drainage of the lesser omentum pancreatic area may be required. If there is no biliary obstruction, non-surgical treatment should be performed first, and further diagnosis and treatment should be carried out as soon as the condition improves. The causes of biliary disease are sometimes hidden, such as biliary sludge obstruction, which needs to be identified through close clinical observation, liver function tests and imaging examinations. For patients who are not responding to non-surgical treatment and who are suspected of having biliary obstruction, ERCP can be performed to clarify the cause of the biliary disease and catheter drainage can be placed at the same time.

(2) Hyperlipidemic acute pancreatitis: This case has increased significantly in recent years. Therefore, when the patient is admitted to the hospital, it is important to inquire about the patient's history of hyperlipidemia, fatty liver, and familial hyperlipidemia, as well as whether he or she has taken medications that may increase blood lipids. When drawing blood from the vein, pay attention to whether the plasma has become milky. Early monitoring of blood lipids is required. Triglycerides >11.3mmol/L are prone to acute pancreatitis and need to be reduced to below 5.65mmol/L in a short period of time. Such patients should limit the use of fat emulsions and avoid the use of drugs that may increase blood lipids. Drug treatment can use small doses of low molecular weight heparin and insulin, mainly to increase the activity of lipoproteinase and accelerate the degradation of chylomicrons; rapid lipid-lowering technologies include blood lipid adsorption and plasma exchange.

(3) Alcoholic acute pancreatitis: In view of the possible pathogenic mechanism of alcoholic acute pancreatitis, emphasis is placed on reducing pancreatic juice secretion, gastric acid secretion, and improving duodenal acidification; emphasis is placed on relieving Oddi sphincter spasm and improving pancreatic juice drainage.

(4) Other causes: For other causes that can be discovered, timely treatment should be given to the cause. For example, hypercalcemic acute pancreatitis is mostly related to hyperparathyroidism, which requires calcium-lowering treatment and corresponding parathyroid surgery. For patients with unknown etiology, while choosing appropriate treatment according to the stage of the disease, carefully observe whether any hidden causes appear.

The above are the relevant treatment methods for severe acute pancreatitis. We can choose a treatment method that suits us according to our actual needs. Remember not to delay the treatment time, and seek treatment early and recover early.