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Necrotizing Pancreatitis

  • Motokazu Sugimoto
  • David P. Sonntag
  • L. William Traverso
Chapter

Abstract

In patients with acute pancreatitis and severe inflammation, the presence of necrosis and pancreatic ductal disruption should be sought through imaging modalities. Minimally invasive “step-up” approach starting with percutaneous catheter drainage (PCD) is the primary treatment strategy for those patients with pancreatic collection and clinical signs of continuous pancreatic juice leakage. Early, proactive PCD maneuvers should be used to achieve effective drainage with patent catheters at the site of pancreatic ductal disruption and to avoid systemic inflammatory response syndrome, organ failure, or mortality. Surgical debridement is the last resort. Since these patients may require radiologic, endoscopic, and/or surgical expertise, they should be treated with multidisciplinary team approach.

Keywords

Necrotizing pancreatitis Pancreatic ductal disruption Percutaneous catheter drainage Endoscopic drainage Surgical debridement Computed tomography Multidisciplinary team 

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Copyright information

© Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) 2020

Authors and Affiliations

  • Motokazu Sugimoto
    • 1
  • David P. Sonntag
    • 2
  • L. William Traverso
    • 3
  1. 1.Department of Hepatobiliary and Pancreatic SurgeryNational Cancer Center Hospital EastKashiwa, ChibaJapan
  2. 2.Department of Interventional RadiologySt. Luke’s Health SystemBoiseUSA
  3. 3.Center for Pancreatic and Liver DiseaseSt. Luke’s Health SystemBoiseUSA

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