Abstract
There is general agreement among clinicians and pancreatologists that pancreatic infection is the most important causal factor of lethal outcome in human acute pancreatitis today [1–3]. Bacterial contamination of pancreatic necrosis has been demonstrated in 40%–70% of patients suffering from necrotizing pancreatitis [4–8], and it has been shown that the frequency of positive cultures increases directly with the duration and extent of necrosis. The necroses in 24% of patients with necrotizing pancreatitis operated on during the first week after hospitalization showed bacterial contamination. This percentage increased to 36% in the second week and to 72% in the third week; thereafter a decrease was found to 32% [9]. Bacterial contamination of pancreatic necrosis occurs early and frequently, as verified by Bassi in a similar study and by Gerzof with the aid of computed tomography (CT)-guided fine needle aspiration and Gram staining [5, 6].
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Buggy BP, Nostrant TT (1983) Lethal pancreatitis. Am J Gastroenterol 78:810–814
Allardyce DB (1987) Incidence of necrotizing pancreatitis and factors related to mortality. Am J Surg 154:295–299
Beger HG, Biichler M (1986) Decision-making in surgical treatment of acute pancreatitis: operative or conservative management of necrotizing pancreatitis? Theor Surg 1:61–68
Beger HG, Krautzberger W, Bittner R, Biichler M, Block S (1986) Bacterial contamination of pancreatic necrosis. A prospective clinical study. Gastroenterology 91:433–438
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
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
Jones CE, Polk HC, Fulton RL (1975) Pancreatic abscess. Am J Surg 129:44–47
Becker JM, Pemberton JH, DiMagno EP, Ilstrup DM, Mcllrath DC, Dozois RR (1984) Prognostic factors in pancreatic abscess. Surgery 96:455–460
Beger HG, Biichler M, Bittner R, Block S, Nevalainen T, Roscher R (1988) Necrosectomy and postoperative local lavage in necrotizing pancreatitis. Br J Surg 75:207–212
Malangoni MA, Richardson JD, Shallcross JC, Sciler JG, Polk HC (1986) Factors contributing to fatal outcome after treatment of pancreatic abscess. Ann Surg 203:605–613
Evans FC (1969) Pancreatic abscess. Am J Surg 117:537–540
Cramer SI, Tan EGC, Warren KW, Braasch JW (1975) Pancreatic abscess: a critically analysis of 113 cases. Am J Surg 129:426–431
Bradley EL, Fulenwider JT (1984) Open treatment of pancreatic abscess. Surg Gynecol Obstet 159:509–513
Gerzof SG, Robbins AJ, Johnson WC, Birkett DH, Nabseth DC (1981) Percutaneous catheter drainage of abdominal abscess: a five year experience. N Engl J Med 305:653–657
van Sonnenberg E, Wing VW, Casola G, Nakamoto SK, Mueller PR, Ferrucci JT, Halasz NA, Simeone JF (1984) Temporizing effect of percutaneous drainage of complicated abscesses in critically ill patients. AJR 142:821–826
Warshaw AL (1974) Inflammatory masses following acute pancreatitis. Surg Gynecol Obstet 139:69–81
Wells CL, Rotstein OD, Pruett TL, Simmons RL (1986) Intestinal bacteria translocate into experimental intra-abdominal abscesses. Arch Surg 121:102–106
Lange JF, van Gool J, Tytgat GNJ (1985) The protective effect of a reduction in intestinal flora on mortality of acute haemorrhagic pancreatitis in the rat. Hepatogastroenterology 34:28–30
Büchler M, Malfertheiner P, Schoetensack C, Uhl W, Beger HG (1986) Sensitivity of antiproteases, complement factors and C-reactive protein in detecting pancreatic necrosis. Results of a prospective clinical study. Int J Pancreatol 1:227–235
Büchler M (1991) Objectivation of the severity of acute pancreatitis. Hepato- Gastroenterol 38:101–108
Mc Mahon MJ, Bowen M, Mayer AD, Cooper EH (1984) Relationship of α2-macroglobulin and other antiproteases to the clinical features of acute pancreatitis. Am J Surg 147:164–169
Uhl W, Büchler M, Malfertheiner P, Martini M, Beger HG (1991) PMN- Elastase in comparison with CRP, antiproteases and LDH as indicators of necrosis in human acute pancreatitis. Pancreas 6:253–259
Gross V, Schölmerich J, Leser HG (1989) Wertigkeit von Leukozytenelastase, C-reaktiven Protein und Proteaseninhibitoren für die Prognose der akuten Pankreatitis. Klin Wochenschr 67:237 (abstract)
Schröder T, Kivilaakso E, Lempinen M (1984) A new method for the diagnosis of acute hemorrhagic necrotising pancreatitis using contrast-enhanced CT. Gastrointest Radiol 9:27–30
Block S, Maier W, Clausen C, Bittner R, Büchler M, Malfertheiner P, Beger HG (1986) Identification of pancreas necrosis in severe acute pancreatitis. Gut 27:1035–42
Balhazar EJ (1989) CT diagnosis and staging of acute pancreatitis. Rad Clin North Am 27:19–37
Bradley EL, Murphy F, Ferguson C (1989) Prediction of pancreatic necrosis by dynamic pancreatography. Ann Surg 210:495–504
Gerzof SG, Banks PA, Robbins AH (1984) Role of guided percutaneous aspiration in early diagnosis of pancreatic sepsis. Dig Dis Sci 29:950 (abstract)
Büchler M, Malfertheiner P, Uhl W, Beger HG (1988) Conservative treatment of necrotizing pancreatitis in patients with minor pancreatic necrosis. Pancreas 3:592 (abstract)
Beger HG, Uhl W (1990) Severe acute pancreatitis. II: The surgical approach. Clin Int Care 1:223–227
Büchler M, Malfertheiner P, Frieß H, Bittner R, Vanek E, Schlegel P, Beger HG (1989) The penetration of antibiotics into human pancreas. Infection 17: 20–25
Craig RM, Dordal E, Myles L (1975) The use of ampicillin in acute pancreatitis. Ann Int Med 83:831–832
Howes R, Zuidema GD, Cameron JL (1975) Evaluation of prophylactic antibiotics in acute pancreatitis. J Surg Res 18:197–200
Finch WT, Sawyers JL, Schenkers S (1976) A prospective study to determine the efficacy of antibiotics in acute pancreatitis. Ann Surg 183:667–671
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1993 Springer-Verlag Berlin Heidelberg
About this paper
Cite this paper
Uhl, W., Büchler, M., Rau, B., Beger, H.G. (1993). Bacterial Infection and the Role of Fine Needle Aspiration. In: Beger, H.G., Büchler, M., Malfertheiner, P. (eds) Standards in Pancreatic Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-77437-9_12
Download citation
DOI: https://doi.org/10.1007/978-3-642-77437-9_12
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-77439-3
Online ISBN: 978-3-642-77437-9
eBook Packages: Springer Book Archive