Th Dugernier1, J Dewaele, P F Laterre. 1. Department of Intensive Care and Emergency Medicine, St Luc University Hospital, Brussels, Belgium.
Abstract
BACKGROUND: About 20% of the patients with acute pancreatitis may run a rapidly progressive or fulminant course resulting in the multiple organ dysfunction syndrome with or without accompanying sepsis. In this subset of patients, the mortality rate still ranges from less than 10% with sterile to over 30% with infected pancreatic necrosis. The goal of this review is to assess the available treatment strategies to allow the development of a formalized surgical approach to those patients. METHODS: A literature review of management of acute pancreatitis. RESULTS AND CONCLUSION: Over the past 20 years, there has been a substantial change in the surgical management of severe acute pancreatitis. This change has been away from a preventive surgery based on early major interventions towards a surgery of complications based increasingly on less aggressive options that take place at a later stage of the attack with specific criteria governing the timing of surgical therapy. Non-surgical options remain more than ever the cornerstone of management in many of these patients.
BACKGROUND: About 20% of the patients with acute pancreatitis may run a rapidly progressive or fulminant course resulting in the multiple organ dysfunction syndrome with or without accompanying sepsis. In this subset of patients, the mortality rate still ranges from less than 10% with sterile to over 30% with infected pancreatic necrosis. The goal of this review is to assess the available treatment strategies to allow the development of a formalized surgical approach to those patients. METHODS: A literature review of management of acute pancreatitis. RESULTS AND CONCLUSION: Over the past 20 years, there has been a substantial change in the surgical management of severe acute pancreatitis. This change has been away from a preventive surgery based on early major interventions towards a surgery of complications based increasingly on less aggressive options that take place at a later stage of the attack with specific criteria governing the timing of surgical therapy. Non-surgical options remain more than ever the cornerstone of management in many of these patients.
Authors: Joana C Branco; Mariana F Cardoso; Luís Carvalho Lourenço; Liliana Santos; David Valadas Horta; Élia Coimbra; Jorge A Reis Journal: GE Port J Gastroenterol Date: 2017-12-07