《2025年国际胰腺病学会急性胰腺炎修订指南》解读

Interpretation of the International Association of Pancreatology revised guidelines on acute pancreatitis 2025

摘要:

2025年国际胰腺病学会联合美国胰腺协会、欧洲胰腺俱乐部、印度胰腺俱乐部及日本胰腺协会等成员发布了《2025年国际胰腺病学会急性胰腺炎修订指南》。该指南是对2013年版指南的全面修订，基于近10年高质量证据（尤其是随机对照试验），涵盖疼痛管理、液体治疗、营养支持、感染性坏死处理、并发症管理、出院及随访、复发预防等18个领域，共提出96条推荐意见，强调个体化治疗。更新内容对规范临床实践、提升急性胰腺炎治疗效果具有重要指导意义，并为未来研究（如靶向治疗应用）指明了方向。然而，指南存在部分推荐证据等级不高、特殊情境适用性待验证，以及未充分考虑经济负担和成本效益等局限性。

Abstract:

In 2025, the International Association of Pancreatology (IAP), in collaboration with the American Pancreatic Association, European Pancreatic Club, Indian Pancreas Club, and Japan Pancreas Society, released the International Association of Pancreatology revised guidelines on acute pancreatitis 2025. This edition represents a comprehensive revision of the 2013 guidelines, based on high-quality evidence accumulated over the past decade, particularly randomized controlled trials. The guidelines encompass 18 key areas-including pain management, fluid therapy, nutritional support, management of infected necrosis, complication control, discharge and follow-up, and recurrence prevention-offering a total of 96 recommendations that emphasize individualized treatment. These updates provide important guidance for standardizing clinical practice and improving outcomes in acute pancreatitis, while also indicating future research directions such as the development of targeted therapies. However, some recommendations remain limited by lower evidence quality, uncertain applicability in specific clinical settings, and insufficient consideration of economic burden and cost-effectiveness.