Skip to main content

Surgical Treatment of Acute Pancreatitis

  • Chapter
Book cover Pancreatic Disease

Abstract

Former classifications of acute pancreatitis have been based on the etiology of the disease. This has led to great confusion, as comparison of the patients with regard to course and severity of the disease and outcome has been hampered. During the past decades, the definition of acute pancreatitis has undergone considerable modifications. The current classification has been defined by the Atlanta consensus conference. It is based on the clinical picture of the disease and distinguishes between mild and severe courses [1, 2].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Bradley EL III (1993) A clinically based classification system for acute pancreatitis. Arch Surg 128:586–590

    PubMed  Google Scholar 

  2. Frey C, Reber HA (1993) Clinically based classification system for acute pancreatitis. Pancreas 8:738–741

    Article  PubMed  CAS  Google Scholar 

  3. Bittner R, Block S, Büchler M, Beger HG (1987) Pancreatic abscess and infected pancreatic necrosis. Different local septic complications in acute pancreatitis. Dig Dis Sci 32:1082–1087

    Article  PubMed  CAS  Google Scholar 

  4. Nordback IH, Auvinen OA (1985) Long-term results after pancreas resection for acute necrotizing pancreatitis. Br J Surg 72:687–689

    Article  PubMed  CAS  Google Scholar 

  5. Ranson JC, Rifkind KM, Roses DF, Fink SD, Eng K, Spencer FC (1974) Prognostic signs and the role of operative management in acute pancreatitis. Surg Gynecol Obstet 139:69

    PubMed  CAS  Google Scholar 

  6. Acosta JM, Rossi RR, Galli OM, Pellegini CA, Skinner DB (1978) Early surgery for gallstone pancreatitis: evaluation of a systemic approach. Surgery 83:367–370

    PubMed  CAS  Google Scholar 

  7. Bradley EL, Allen K (1991) A prospective longitudinal study of observation versus surgical intervention in the management of necrotizing pancreatitis. Am J Surg 161:19–25

    Article  PubMed  Google Scholar 

  8. Rau B, Pralle U, Uhl W, Schoenberg MH, Beger HG (1995) Management of sterile necrosis in instances of severe acute pancreatitis. J Am Coll Surg 181:279–288

    PubMed  CAS  Google Scholar 

  9. Karimgani I, Porter KA, Langevin RE, Banks PA (1992) Prognostic factors in sterile pancreatic necrosis. Gastroenterology 103:1636–1640

    PubMed  CAS  Google Scholar 

  10. Bradley EL (1987) Management of infected pancreatic necrosis by open drainage. Ann Surg 206:542–550

    Article  PubMed  Google Scholar 

  11. Sarr MG, Nagorney DM, Much P Jr, Farnell MB, Johnson CD (1991) Acute necrotizing pancreatitis: management by planned, staged pancreatic necrosectomy/débridement and delayed primary wound closure over drains. Br J Surg 78:576–581

    Article  PubMed  CAS  Google Scholar 

  12. Beger HG, Bittner R, Büchler M, Block S, Nevalainen TJ, Roscher R (1988) Necrosectomy and postoperative local lavage in necrotizing pancreatitis. Br J Surg 75:207–212

    Article  PubMed  CAS  Google Scholar 

  13. Isenmann R, Büchler MW (1994) Infection and acute pancreatitis. Br J Surg 81:1707–1708

    Article  PubMed  CAS  Google Scholar 

  14. Fedorak IJ, Ko TC, Djuricin G, McMahon M, Thompson KR, Prinz A (1991) Secondary pancreatic infections: are they distinct clinical entities? Surgery 161:19

    Article  Google Scholar 

  15. Widdison AL, Karanjia ND (1993) Pancreatic infection complicating acute pancreatitis. Br J Surg 80:148–154

    Article  PubMed  CAS  Google Scholar 

  16. Isenmann R, Rau B, Schoenberg MH, Beger HG (1998) Determinants of organ failure (OF) in patients with necrotizing pancreatitis (NP). Gastroenterology 114:A470

    Article  Google Scholar 

  17. de Beaux AC, Palmer KR, Carter DC (1995) Factors influencing morbidity and mortality in acute pancreatitis; an analysis of 279 cases. Gut 37:121–126

    Article  PubMed  Google Scholar 

  18. Gerzof SG, Banks PA, Robbins AH, Johnson WC, Spechler SJ, Wetzner SM, Snider JM, Langevin RE, Jay ME (1987) Early diagnosis of pancreatic infection by computed tomography-guided aspiration. Gastroenterology 93:1315–1320

    PubMed  CAS  Google Scholar 

  19. Isenmann R, Büchler M, Uhl W, Pralle U, Malfertheiner P, Bialas C, Meyer H, Beger HG (1992) When does infection of pancreatic necrosis happen? Pancreas 7:A742

    Google Scholar 

  20. Beger HG, Bittner R, Block S, Büchler M (1986) Bacterial contamination of pancreatic necrosis — a prospective clinical study. Gastroenterology 91:433–438

    PubMed  CAS  Google Scholar 

  21. Bassi C, Falconi M, Girelli R, Nifosi F, Elio A, Martini N, Pederzoli P (1989) Microbiological findings in severe pancreatitis. Surg Res Comm 5:1–4

    Google Scholar 

  22. Wells CL, Rotstein OD, Pruett TL, Simmons RL (1986) Intestinal bacteria translocate into experimental intra-abdominal abscesses. Arch Surg 121:102–107

    PubMed  CAS  Google Scholar 

  23. Widdison AL, Karanjia ND, Reber HA (1994) Routes of spread of pathogens into the pancreas in a feline model of acute pancreatitis. Gut 35:1306–1310

    Article  PubMed  CAS  Google Scholar 

  24. Medich DS, Lee TK, Melhem MF, Rowe MI, Schraut WH, Lee KW (1993) Pathogenesis of pancreatic sepsis. Am J Surg 165:46–52

    Article  PubMed  CAS  Google Scholar 

  25. Rau B, Pralle U, Mayer JM, Beger HG (1998) Role of ultrasonographically guided fine-needle aspiration cytology in the diagnosis of infected pancreatic necrosis. Br J Surg 85:179–184

    Article  PubMed  CAS  Google Scholar 

  26. Stiles GM, Berne TV, Thommen VD, Molgaard CP, Boswell WD (1990) Fine needle aspiration of pancreatic fluid collections. Am Surg 56:764–768

    PubMed  CAS  Google Scholar 

  27. Hiatt JR, Fink AS, King W II, Pitt HA (1987) Percutaneous aspiration of peripancreatic fluid collections: a safe method to detect infection. Surgery 101:523–530

    PubMed  CAS  Google Scholar 

  28. Barkin JS, Pereiras R, Hill M, Levi J, Isikoff M, Rogers AI (1982) Diagnosis of pancreatic abscess via percutaneous aspiration. Dig Dis Sci 27:1011–1014

    Article  PubMed  CAS  Google Scholar 

  29. Chikh-Torab F, Berger D, Buttenschön K, Pralle U, Beger HG (1996) Inflammatory mediators in acute pancreatitis: high concentrations in the peripancreatic fluid. Digestion 57:156A

    Google Scholar 

  30. Rünzi M, Layer P, Niebel W, Eigler FW, Goebell H (1996) Infected necrosis in severe acute pancreatitis: an indication for immediate surgery? Pancreas 13:455

    Article  Google Scholar 

  31. Dubner H, Steinberg W, Hill M, Bassi C, Chardavoyne R, Bank S (1996) Infected pancreatic necrosis and peripancreatic fluid collections: serendipitous response to antibiotic and medical therapy in three patients. Pancreas 12:298

    Article  PubMed  CAS  Google Scholar 

  32. Pederzoli P, Bassi C, Vesentini A, Campedelli A (1993) A randomized multicenter clinical trial of antibiotic prophylaxis of septic complications in acute necrotizing pancreatitis with imipenem. Surg Gynecol Obstet 176:480–483

    PubMed  CAS  Google Scholar 

  33. Sainio V, Kemppainen E, Puolakkainen P, Taavitsainen M, Kivisaari L, Valtonen V, Haapiainen R, Schröder T, Kivilaakso E (1995) Early antibiotic treatment in acute necrotising pancreatitis. Lancet 346:663–667

    Article  PubMed  CAS  Google Scholar 

  34. Luiten EJT, Hop WCJ, Lange JF, Bruining HA (1995) Controlled clinical trial of selective decontamination for the treatment of severe acute pancreatitis. Ann Surg 222:57–65

    Article  PubMed  CAS  Google Scholar 

  35. Powell JJ, Miles R, Siriwardena AK (1998) Antibiotic prophylaxis in the initial management of severe acute pancreatitis. Br J Surg 85:582–587

    Article  PubMed  CAS  Google Scholar 

  36. Ho SH, Frey CF (1997) The role of antibiotic prophylaxis in severe acute pancreatitis. Arch Surg 132:487–493

    PubMed  CAS  Google Scholar 

  37. Steinberg WM, Schlesselmann SE (1987) Treatment of acute pancreatitis. Gastroenterology 93:1420–1427

    PubMed  CAS  Google Scholar 

  38. Kingsnorth AN, Galloway SW, Formela LJ (1995) Randomized, double-blind phase II trial of lexipafant, a platelet-activating factor antagonist, in human acute pancreatitis. Br J Surg 82:1414–1420

    Article  PubMed  CAS  Google Scholar 

  39. Alexandre JH, Guerrieri MT (1981) Role of total pancreatectomy in the treatment of necrotizing pancreatitis. World J Surg 5:369–377

    Article  PubMed  CAS  Google Scholar 

  40. Smadja C, Bismuth H (1986) Pancreatic débridement in acute necrotizing pancreatitis: an obsolete procedure. Br J Surg 73:408–410

    Article  PubMed  CAS  Google Scholar 

  41. Allardyce DB (1987) Incidence of necrotizing pancreatitis and factors related to mortality. Am J Surg 154:295–299

    Article  PubMed  CAS  Google Scholar 

  42. Wilson C, McArdle CS, Carter DC, Imrie CW (1988) Surgical treatment of acute necrotizing pancreatitis. Br J Surg 75:119–123

    Article  Google Scholar 

  43. Teerenhovi O, Nordback I, Eskola J (1989) High volume lesser sac lavage in acute necrotizing pancreatitis. Br J Surg 76:370–373

    Article  PubMed  CAS  Google Scholar 

  44. Howard JM (1989) Delayed débridement and external drainage of massive pancreatic or peripancreatic necrosis. Surg Gynecol Obstet 168:25–29

    PubMed  CAS  Google Scholar 

  45. Villazon A, Villazon O, Terrazas F, Rana R (1991) Retroperitoneal drainage in the management of the septic phase of severe acute pancreatitis. World J Surg 15:103–108

    Article  PubMed  CAS  Google Scholar 

  46. Wertheimer MD, Norris CS (1986) Surgical management of necrotizing pancreatitis. Arch Surg 121:484–487

    PubMed  CAS  Google Scholar 

  47. Garcia-Sabrido JL, Tallado J, Christou NV, Polo JR, Valdecanatos E (1988) Treatment of severe intra-abdominal sepsis and/or necrotic foci by open-abdomen approach. Arch Surg 123:152–156

    PubMed  CAS  Google Scholar 

  48. Waclawiczek HW, Chmelizek F, Heinerman M (1992) Das Laparostoma (open packing) im Behandlungskonzept infizierter Pankreasnekrosen. Wien Klin Wochenschr 104:443–447

    PubMed  CAS  Google Scholar 

  49. Orlando R III, Welch JP, Akbari CM, Bloom GP, Macaulay WP (1993) Techniques and complications in open drainage for infected pancreatic necrosis. Surg Gynecol Obstet 177:65–71

    PubMed  Google Scholar 

  50. Bradley EL III (1993) A fifteen-year experience with open drainage for infected pancreatic necrosis. Surg Gynecol Obstet 177:215–222

    PubMed  Google Scholar 

  51. Függer R, Götzinger P, Sautner T (1995) Necrosectomy and laparostomy — a combined therapeutic concept in acute necrotizing pancreatitis. Eur J Surg 161:103–107

    PubMed  Google Scholar 

  52. Gebhardt C, Gall FP (1981) Importance of peritoneal irrigation after surgical treatment of hemorrhagic, necrotizing pancreatitis. World J Surg 5:379–385

    Article  PubMed  CAS  Google Scholar 

  53. Larvin M, Chalmers AG, Robinson PJ, MacMahon MJ (1989) Débridement and closed cavity irrigation for the treatment of pancreatic necrosis. Br J Surg 76:465–471

    Article  PubMed  CAS  Google Scholar 

  54. Pederzoli P, Bassi C, Vesentini S, et al (1990) Retroperitoneal and peritoneal drainage and lavage in the treatment of severe necrotizing pancreatitis. Surg Gynecol Obstet 170:197–203

    PubMed  CAS  Google Scholar 

  55. Beger HG, Krautzberger W, Bittner R, Block S, Büchler M (1985) Results of surgical treatment of necrotizing pancreatitis. World J Surg 9:972–979

    Article  PubMed  CAS  Google Scholar 

Download references

Authors

Rights and permissions

Reprints and permissions

Copyright information

© 1999 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Beger, H.G., Rau, B., Mayer, J., Isenmann, R. (1999). Surgical Treatment of Acute Pancreatitis. In: Pancreatic Disease. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-60068-5_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-60068-5_8

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-65357-8

  • Online ISBN: 978-3-642-60068-5

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics