Necrotizing acute pancreatitis current status - emerging new strategies in surgical management
| Autor: | Christos Lappas, Panayiotis Kokoropoulos, Aikaterini Mastoraki, Dimitrios Sampanis, Vassilios Smyrniotis, George H. Sakorafas |
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| Rok vydání: | 2011 |
| Předmět: |
Microbiology (medical)
Pharmacology medicine.medical_specialty Percutaneous Abdominal compartment syndrome business.industry Pancreatitis Acute Necrotizing General Medicine Infected pancreatic necrosis medicine.disease Surgery High morbidity medicine Molecular Medicine Acute pancreatitis Humans Necrotizing pancreatitis business Surgical treatment Open abdomen |
| Zdroj: | Infectious disorders drug targets. 12(2) |
| ISSN: | 2212-3989 |
| Popis: | Despite that pancreatic necrosis complicates only 15 % of cases of acute pancreatitis (AP), it is associated with high morbidity and considerable mortality. In an attempt to improve prognosis, many surgical strategies have been described during the last few decades. Currently, necrosectomy remains the cornerstone in the surgical treatment of infected pancreatic necrosis and in selected cases of sterile necrotizing pancreatitis. Following necrosectomy, continuous closed lavage is recommended by many authors, while closed abdominal packing /drainage and repeated planned necrosectomies- commonly using the zipper technique-are also acceptable alternative strategies. Open abdomen (laparostomy) is rarely indicated in carefully selected cases (typically in abdominal compartment syndrome associated with necrotizing AP). During the last decade, minimally invasive techniques (including percutaneous drainage, retroperitoneal endoscopic approach, transgastric endoscopic approach etc) have been extensively studied by some groups not only in the management of pancreatic abscesses and / or pseudocysts, but also as primary methods of treatment of necrotizing AP. Results have been impressive, but experience currently is limited to only a few centers around the world. |
| Databáze: | OpenAIRE |
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