Invasive intervention timing for infected necrotizing pancreatitis: Late invasive intervention is not late for collection

Xiao, Nian-Jun; Cui, Tingting; Liu, Fang; Li, Wen

doi:10.12998/wjcc.v10.i23.8057

Cited by 4 publications

(4 citation statements)

References 19 publications

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“…We read with great interest the recent paper by Xiao et al [ 1 ], and we would like to express our satisfaction and congratulations for their excellent work. It is a well-written comprehensive opinion review presenting the current data on the serious condition of infected necrotizing pancreatitis (INP).…”

Section: To the Editormentioning

confidence: 96%

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Management of infected acute necrotizing pancreatitis

Pavlidis¹,

Pavlidis²

2023

World J Clin Cases

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Necrotizing or severe pancreatitis represents approximately 10%-20% of acute pancreatitis. 30%-40% of patients with acute necrotizing pancreatitis (ANP) will develop debris infection through translocation of intestinal microbial flora. Infected ANP constitutes a serious clinical condition and is complicated by severe sepsis with high mortality rates of up to 40% despite progress in current intensive care. The timely detection of sepsis is crucial. The Quick Sequential Organ Failure Assessment score, procalcitonin levels > 1.8 ng/mL and increased lactates > 2 mmol/L (> 18 mg/dL), indicate the need for urgent management. The escalated step-by-step management protocol starts with broad-spectrum antibiotics, percutaneous drainage or endoscopic management, and ends with surgical management if needed. The latter includes necrosectomy (either laparoscopic or traditional open surgery), peritoneal lavage and extensive drainage. This management protocol increases the chance of survival to approximately 60% in patients with otherwise fatal cases. Any treatment choice must be individualized, and the timing is critical.

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Section: To the Editormentioning

confidence: 96%

“…The escalated step-by-step management consists of endoscopic management, interventional methods and surgical approaches. The timing of interventional application is still under debate[ 1 , 3 , 4 , 6 ]. However, early recognition and timely debridement are crucial.…”

Section: To the Editormentioning

confidence: 99%

Management of infected acute necrotizing pancreatitis

Pavlidis¹,

Pavlidis²

2023

World J Clin Cases

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“…The generally accepted recommendation for the first invasive interventions is at least 4 wk after pancreatitis until confirmation of INP encapsulation[ 17 , 45 - 47 ]. These delayed endoscopic interventions in INP demonstrates excellent clinical success, lower reintervention rates, and lower mortality[ 48 , 49 ]. At the same time, early drainage, whose efficacy, safety, and necessity of early drainage still need to be investigated, has received much attention recently.…”

Section: Endoscopic Transluminal Drainagementioning

confidence: 99%

Endoscopic transluminal drainage and necrosectomy for infected necrotizing pancreatitis: Progress and challenges

Zeng¹,

Yang²,

Zhang³

2023

World J Clin Cases

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Infected necrotizing pancreatitis (INP) represents a severe condition in patients with acute pancreatitis. Invasive interventions are recommended in symptomatic INP. Growing evidence has suggested interventional strategies of INP evolving from traditional surgery to minimally invasive step-up endoscopic procedures. However, there is still no standardized protocol for endoscopic interventions. Recently, various studies have been published about the endoscopic management of INP. This article reviews published articles and guidelines to present the progress and challenges of endoscopic transluminal drainage and necrosectomy in INP.

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“…Przy podejrzeniu bądz potwierdzeniu zakażenia martwiczego zapalenia trzustki z towarzyszącym pogorszeniem stanu ogólnego, zaleca się wykonanie zabiegu zgodnie z podejściem SUAP (step-up approach) w pierwszej kolejności minimalnie inwazyjnego np. drenażu przezskórnego lub endoskopowego [20]. W razie nieskuteczności wyżej wymienionych procedur przeprowadza się zabieg operacyjny, najlepiej mało inwazyjny, w ostateczności otwartą operację.…”

Section: Leczenie Inwazyjneunclassified

Evaluation of diagnostic and therapeutic procedures in patients with acute pancreatitis

Potyrała,

Tomczak,

Kazzi

et al. 2023

J Educ Health Sport

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Introduction and purpose: Acute pancreatitis remains a clinically significant problem worldwide and in Poland, where its incidence is observed to be twice as high as in the global population. The aim of this study is to describe the latest available guidelines for managing patients diagnosed with acute pancreatitis, including diagnostic methods, radiological approaches, as well as conservative and invasive therapeutic treatment. Materials and Methods: The literature available on PubMed, Scopus, Google Scholar databases, and guidelines from the Polish Society of Gastroenterology was reviewed using the words: „acute pancreatitis”, „pancreas", "AP treatment", and „acute pancreatitis management”. Description of the state of knowledge: Patients with suspicion of acute pancreatitis are mainly diagnosed based on their symptoms using the Revised Atlanta Classification comprising of clinical symptoms, elevated pancreatic enzymes level, and imaging test results. The recommended therapeutic management for patients with acute pancreatitis underlines the importance of conservative treatment before the implementation of invasive procedures, the choice of which should be based on the severity and form of the condition. Summary: The existing recommendations regarding the diagnostic approach in acute pancreatitis emphasize the importance of correlating symptoms with radiological findings obtained through ultrasound, which is a quick and widely accessible diagnostic tool. In therapeutic management, conservative treatment remains significant with the early implementation of nutritional support, along with the appropriate method and timing of surgical intervention depending on the form of acute pancreatitis and the presence of infection.

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Invasive intervention timing for infected necrotizing pancreatitis: Late invasive intervention is not late for collection

Cited by 4 publications

References 19 publications

Management of infected acute necrotizing pancreatitis

Management of infected acute necrotizing pancreatitis

Endoscopic transluminal drainage and necrosectomy for infected necrotizing pancreatitis: Progress and challenges

Evaluation of diagnostic and therapeutic procedures in patients with acute pancreatitis

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