THE MORPHOLOGICAL BASIS FOR THE EVOLUTION OF ACUTE-PANCREATITIS INTO CHRONIC-PANCREATITIS
THE MORPHOLOGICAL BASIS FOR THE EVOLUTION OF ACUTE-PANCREATITIS INTO CHRONIC-PANCREATITIS
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DOI：
10.1007/bf01605976
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发表时间：
1992-01-01
期刊：
影响因子：
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通讯作者：
MAILLET, B
中科院分区：
文献类型：
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作者：
KLOPPEL, G;MAILLET, B
结论坏死-纤维化序列是慢性胰腺炎发生发展的基本过程。这一顺序意味着急性胰腺炎可能是慢性胰腺炎的原因，而急性胰腺炎很可能是严重的复发形式。为了使这一概念与个体患者及其疾病的自然病程相关，必须仔细评估急性胰腺炎坏死的程度和分布模式，并考虑可能发生的恢复过程（即恢复完整、假性囊肿、胰腺内纤维化）。这样的分析表明，只有在重症急性胰腺炎后，只有在某些条件下，如发生胰腺内坏死涉及主管，慢性胰腺炎的发展是可以预期的。每例胰腺炎患者的个体性要求对胰腺进行全面的临床和形态学评估，以便为该疾病分配适当的治疗并阻止其进展（Warshaw 1990）。
ConclusionsThere are many reasons to believe that the necrosis-fibrosis sequence is the basic pathogenetic event in the evolution of chronic pancreatitis. This sequence implies that acute pancreatitis, probably in its severe relapsing form, may be the cause of chronic pancreatitis. To make this concept relevant to the individual patient and the natural course of his/her disease, the extent and distribution pattern of necrosis in acute pancreatitis has to be carefully evaluated with regard to the restitutional processes (i.e. restitutio ad integrum, pseudocyst, intrapancreatic fibrosis) that may follow. Such an analysis reveals that only after severe acute pancreatitis and only under certain conditions, such as the occurrence of intrapancreatic necrosis involving the main duct, development of chronic pancreatitis can be anticipated. The individuality of each patient's pancreatitis demands a thorough clinical and morphological assessment of the pancreas in order to assign the appropriate therapy to this disease and halt its progression (Warshaw 1990).