Surgical Management of Acute Pancreatitis

Martin, J. Kirk; Heerden, Jon A. van; Bess, Michael A.

doi:10.1016/s0025-6196(12)61260-9

Cited by 21 publications

(4 citation statements)

References 64 publications

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“…The conservative, non-surgical approach to severe pancreatitis persisted for many years. During the past decade, however, it has become clear that certain patients with severe pancreatitis do benefit from operative intervention, and that they will not survive without [16]. Nevertheless, the decision regarding whether to and when to operate is often difficult and requires careful clinical judgement.…”

Section: Historical Perspectivementioning

confidence: 99%

The management of severe acute necrotising pancreatitis: an evidence-based review of the literature

Wyncoll

1999

Intensive Care Medicine

110

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Clearly the main determinant of outcome in severe acute pancreatitis is the extent of pancreatic necrosis and the subsequent risk for the development of infected necrosis. A thorough assessment using appropriate scoring systems and the early use of dynamic contrast-enhanced CT will highlight those patients likely to benefit from higher dependency or intensive care. Despite numerous suggested specific therapies there is still no Grade A evidence that any confers a significant mortality benefit. However, general supportive measures should include vigorous replacement of fluid losses to correct the circulating volume, correction of electrolyte and glucose abnormalities, and respiratory, cardiovascular and renal support as necessary. Those patients with infected pancreatic necrosis or deteriorating organ systems should undergo surgery. Patients with sterile necrosis should receive a broad-spectrum prophylactic antibiotic which adequately penetrates pancreatic tissue. Due attention should also be paid to nutritional support, for which a jejunal feeding tube with EN is recommended as early as is achievable.

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Section: Historical Perspectivementioning

confidence: 99%

The management of severe acute necrotising pancreatitis: an evidence-based review of the literature

Wyncoll

1999

Intensive Care Medicine

110

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“…Somatostatin wa s originally deve lo ped a s a long-acting growth hormone inhibitor. However, it has other spe cific endocrine action s a nd ha s the potential for tre at ing disorders such as pancreatitis and preventing co mplicatio ns after surge ry (13,18) because it reduce s exoc rine pancreatic se c re tio n (13.17) and indi rectly inhibi ts gastro inte stinal hormone s (19) a nd ga st ric acid. It has produced impressive clinical impro vement in adult s with few side effe cts except for hyperglycemia (18) but had never been used to treat a child as yo ung as this patient.…”

Section: Resultsmentioning

confidence: 99%

Chronic Pancreatitis and Pancreas Divisum in an Infant

Yaffe,

Gutenberger

1989

J. pediatr. gastroenterol. nutr.

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“…It has been recognized for many years that some individuals with necrotizing pancreatitis require surgery in order to maximize their chances for survival 4. Although the indications for operation in this group of patients remain controversial, recent developments have allowed us to refine our management of this difficult problem 5.…”

Section: Introductionmentioning

confidence: 99%

The surgical approach to severe acute pancreatitis

Todd

Reber

1996

J Hep Bil Pancr Surg

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Abstract:The indications for surgery in severe acute pancreatitis include circumstances in which the diagnosis is uncertain, persistent biliary pancreatitis, infected pancreatic necrosis, and some patients with pancreatic abscess. The controversy surrounding surgical treatment for sterile pancreatic necrosis, and situations in which the disease persists in spite of intensive medical management are also addressed. Surgical principles and the merits of open versus closed drainage are reviewed.

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Surgical Management of Acute Pancreatitis

Cited by 21 publications

References 64 publications

The management of severe acute necrotising pancreatitis: an evidence-based review of the literature

The management of severe acute necrotising pancreatitis: an evidence-based review of the literature

Chronic Pancreatitis and Pancreas Divisum in an Infant

The surgical approach to severe acute pancreatitis

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