Severe Acute Pancreatitis Requiring Drainage Therapy: Findings on Computed Tomography as Predictor of Patient Outcome

Heiss, Peter; Bruennler, T.; Salzberger, Bernd; Lang, Sven A.; Langgartner, Julia; Feuerbach, Stefan; Schöelmerich, Juergen; Hamer, OW

doi:10.1159/000320710

Cited by 23 publications

(15 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Six18–24 (reported in seven publications) of the 19 included studies were US based. Of the 13 EU-5 studies, five3 25–28 were conducted in the UK, three each in Germany29–31 and Italy,32–34 and one each in France35 and Spain 36. Overall, most studies were of a retrospective design (13 studies),3 21–23 25–33 were based on single-centre hospitals (13)18–22 24–26 28 29 31 33 35 36 and were principally tertiary referral units for which the reporting was exclusively on patients with SAP (10) 22 23 25–31 33.…”

Section: Resultsmentioning

confidence: 99%

Moderately severe and severe acute pancreatitis : a systematic review of the outcomes in the USA and European Union-5

Sarri¹,

Guo²,

Iheanacho³

et al. 2019

BMJ Open Gastroenterol

View full text Add to dashboard Cite

Background and objectivesThe global incidence of hospitalisation due to acute pancreatitis (AP) has been rising in the recent decades. In the USA alone, there was a 13.2% increase between 2009 and 2012 compared with 2002–2005. There remains a lack of approved treatments to prevent disease progression, leaving many liable to developing complications that include multisystem organ failure (OF) and death. This therapeutic deficit raises questions about the scale of the current burden of illness (BOI) associated with severe forms of AP. The aim of the systematic literature review (SLR) was to assess clinical, humanistic, and economic outcomes associated with moderately severe AP (MSAP) and severe AP (SAP) in the USA and the European Union-5 (EU-5).MethodsSystematic searches were conducted in MEDLINE and Embase to identify studies published in English (between 2007 and 2017) that reported on the BOI of MSAP and/or SAP. Manual searches of ‘grey’ literature sources were also conducted.ResultsThe SLR identified 19 studies which indicated that 15%–20% of patients with AP progress to more severe forms of the disease, up to 10.5% of those with SAP require surgery for complications, and up to 40% die during hospitalisation. By contrast, there appears to be a lack of data on the extent to which SAP affects patients’ quality of life.ConclusionThe available evidence clearly demonstrates that the current management for MSAP and SAP in the USA and EU-5 does not adequately meet patients’ needs. Early identification and intervention for AP is crucial, given the evidence of high rates of morbidity and an associated economic burden that is considerable. Since many patients with the condition present to hospitals at a point when multisystem OF or death is highly likely, there is a particularly urgent need for effective treatment options to prevent disease progression.

show abstract

Section: Resultsmentioning

confidence: 99%

Moderately severe and severe acute pancreatitis : a systematic review of the outcomes in the USA and European Union-5

Sarri¹,

Guo²,

Iheanacho³

et al. 2019

BMJ Open Gastroenterol

View full text Add to dashboard Cite

show abstract

“…When AP is initiated by diverse stimuli, including alcohol consumption and gallstones (7–9), obese patients are more prone to severe AP (SAP). This is a concern because SAP results in 40 to 50% mortality when complicated by acute renal failure, respiratory failure, hypocalcemia, and other manifestations of multisystem organ failure or by large areas of pancreatic necrosis (10, 11). Patients with SAP have increased visceral fat (12), higher serum cytokines [for example, interleukin-6 (IL-6) and monocyte chemotactic protein 1 (MCP-1)], and adipokines (for example, resistin and visfatin) (5, 13), but it is unclear whether these are markers or mediators of injury.…”

Section: Introductionmentioning

confidence: 99%

Lipotoxicity Causes Multisystem Organ Failure and Exacerbates Acute Pancreatitis in Obesity

et al. 2011

View full text Add to dashboard Cite

Obesity increases the risk of adverse outcomes during acute critical illnesses such as burns, severe trauma, and acute pancreatitis. Although individuals with more body fat and higher serum cytokines and lipase are more likely to experience problems, the roles that these characteristics play are not clear. We used severe acute pancreatitis as a representative disease to investigate the effects of obesity on local organ function and systemic processes. In obese humans, we found that an increase in the volume of intrapancreatic adipocytes was associated with more extensive pancreatic necrosis during acute pancreatitis and that acute pancreatitis was associated with multisystem organ failure in obese individuals. In vitro studies of pancreatic acinar cells showed that unsaturated fatty acids were proinflammatory, releasing intracellular calcium, inhibiting mitochondrial complexes I and V, and causing necrosis. Saturated fatty acids had no such effects. Inhibition of lipolysis in obese (ob/ob) mice with induced pancreatitis prevented a rise in serum unsaturated fatty acids and prevented renal injury, lung injury, systemic inflammation, hypocalcemia, reduced pancreatic necrosis, and mortality. Thus, therapeutic approaches that target unsaturated fatty acid–mediated lipotoxicity may reduce adverse outcomes in obese patients with critical illnesses such as severe acute pancreatitis.

show abstract

“…Currently, most researchers think that the surgical indications for the treatment of SAP via the laparoscopic catheter drainage can be properly relaxed, and that the surgical opportunity can be set ahead and should not rigidly adhere to the occurrence of pancreatic infection [10,11]. We think that as long as an obvious exudation around the pancreas can be detected by imaging, drainage via retroperitoneal laparoscopy can be adopted.…”

Section: Discussionmentioning

confidence: 99%

Treatment of severe acute pancreatitis through retroperitoneal laparoscopic drainage

et al. 2011

View full text Add to dashboard Cite

A treatment method based on drainage via retroperitoneal laparoscopy was adopted for 15 severe acute pancreatitis (SAP) patients to investigate the feasibility of the method. Ten patients received only drainage via retroperitoneal laparoscopy, four patients received drainage via both retroperitoneal and preperitoneal laparoscopy, and one patient received drainage via conversion to laparotomy. Thirteen patients exhibited a good drainage effect and were successfully cured without any other surgical treatment. Two patients had encapsulated effusions or pancreatic pseudocysts after surgery, but were successfully cured after lavage and B ultrasound-guided percutaneous catheter drainage. SAP treatment via retroperitoneal laparoscopic drainage is an effective surgical method, resulting in minor injury.

show abstract

Severe Acute Pancreatitis Requiring Drainage Therapy: Findings on Computed Tomography as Predictor of Patient Outcome

Cited by 23 publications

References 20 publications

Moderately severe and severe acute pancreatitis : a systematic review of the outcomes in the USA and European Union-5

Moderately severe and severe acute pancreatitis : a systematic review of the outcomes in the USA and European Union-5

Lipotoxicity Causes Multisystem Organ Failure and Exacerbates Acute Pancreatitis in Obesity

Treatment of severe acute pancreatitis through retroperitoneal laparoscopic drainage

Contact Info

Product

Resources

About