Abstract
Acute pancreatitis is one of the most common gastrointestinal disorders requiring hospitalization. Approximately 20% of pancreatitis patients will develop pancreatic necrosis, which can lead to a systemic inflammatory response, multi-organ system failure, and death. Early intervention is essential to avoid poor outcomes. Open necrosectomy has historically been the treatment of choice. More recently, a step-up approach has become more common. This chapter discusses this approach, which is depicted in the subsequent algorithm.
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References
Donald G, Donahue T, Reber HA, Hines OJ. The evolving management of infected pancreatic necrosis. Am Surg. 2012;78(10):1151–5. Pubmed Central PMCID: 3678520.
van Santvoort HC, Besselink MG, Bakker OJ, Hofker HS, Boermeester MA, Dejong CH, et al. A step-up approach or open necrosectomy for necrotizing pancreatitis. N Engl J Med. 2010;362(16):1491–502.
Dugernier T, Dewaele J, Laterre PF. Current surgical management of acute pancreatitis. Acta Chir Belg. 2006;106(2):165–71.
Petrov MS, Shanbhag S, Chakraborty M, Phillips AR, Windsor JA. Organ failure and infection of pancreatic necrosis as determinants of mortality in patients with acute pancreatitis. Gastroenterology. 2010;139(3):813–20.
Working Group IAPAPAAPG. IAP/APA evidence-based guidelines for the management of acute pancreatitis. Pancreatology. 2013;13(4 Suppl 2):e1–15.
Uhl W, Warshaw A, Imrie C, Bassi C, McKay CJ, Lankisch PG, et al. IAP guidelines for the surgical management of acute pancreatitis. Pancreatology. 2002;2(6):565–73.
Alverdy J, Vargish T, Desai T, Frawley B, Rosen B. Laparoscopic intracavitary debridement of peripancreatic necrosis: preliminary report and description of the technique. Surgery. 2000;127(1):112–4.
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Javed, A.A., Weiss, M.J. (2019). Pancreatic Necrosis. In: Docimo Jr., S., Pauli, E. (eds) Clinical Algorithms in General Surgery . Springer, Cham. https://doi.org/10.1007/978-3-319-98497-1_100
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DOI: https://doi.org/10.1007/978-3-319-98497-1_100
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