Management of Necrotizing Pancreatitis

Overview

Journal World J Gastroenterol

Publisher Baishideng Publishing Group

Specialty Gastroenterology

Date 2002 Jan 31

PMID 11819813

Citations 23

Authors

J Slavin

P Ghaneh

R Sutton

M Hartley

P Rowlands

C Garvey

M Hughes

J Neoptolemos

Affiliations

Soon will be listed here.

Abstract

Infection complicating pancreatic necrosis leads to persisting sepsis, multiple organ dysfunction syndrome and accounts for about half the deaths that occur following acute pancreatitis. Severe cases due to gallstones require urgent endoscopic sphincterotomy. Patients with pancreatic necrosis should be followed with serial contrast enhanced computed tomography (CE-CT) and if infection is suspected fine needle aspiration of the necrotic area for bacteriology (FNAB) should be undertaken. Treatment of sterile necrosis should initially be nonoperative. In the presence of infection necrosectomy is indicated. Although traditionally this has been by open surgery, minimally invasive procedures are a promising new alternative. There are many unresolved issues in the management of pancreatic necrosis. These include, the use of antibiotic prophylaxis, the precise indications for and frequency of repeat CE-CT and FNAB, and the role of enteral feeding.

Citing Articles

When to Intervene in Acute Necrotizing Pancreatitis: A Narrative Review of the Optimal Timing for Intervention Strategies.

Paramythiotis D, Karlafti E, Tsavdaris D, Giakoustidis A, Panidis S, Ioannidis A Medicina (Kaunas). 2024; 60(10).

PMID: 39459378 PMC: 11509130. DOI: 10.3390/medicina60101592.

Pain Management in Acute Pancreatitis: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.

Cai W, Liu F, Wen Y, Han C, Prasad M, Xia Q Front Med (Lausanne). 2022; 8:782151.

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Damage control in penetrating duodenal trauma: less is better - the sequel.

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Vascular endothelial injury and apoptosis in rats with severe acute pancreatitis.

Ge N, Xia Q, Yang Z, Ding Q, Zeng Z Gastroenterol Res Pract. 2015; 2015:235017.

PMID: 25688263 PMC: 4320903. DOI: 10.1155/2015/235017.

Pharmacokinetic and pharmacodynamic comparison of chinese herbal ointment liu-he-dan and micron liu-he-dan ointment in rats with acute pancreatitis.

Zhu S, Chen W, Xiang J, Zhao X, Wan M, Yu Q Evid Based Complement Alternat Med. 2014; 2014:389576.

PMID: 24693322 PMC: 3947679. DOI: 10.1155/2014/389576.

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