Abstract
In the practice of medicine, the definition of “conservative” is often subject to as many and varied interpretations as it is in the field of politics. For the purpose of this discussion, conservative treatment of acute pancreatitis is considered to encompass all therapeutic measures except (a) operative procedures, (b) therapeutic endoscopy, (c) percutaneous placement of drainage catheters, and (d) peritoneal dialysis for indications other than renal failure. It is crucial to distinguish between conservative treatment and nonaggressive treatment. The conservative management of severe acute pancreatitis is quite vigorous and aggressive, focusing on provision of necessary supportive care and early recognition and treatment of any complications.
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
Neoptolemos JP, Carr-Locke DL, London NJ, Bailey IA, James D, Fossard DP (1988) Controlled trial of urgent endoscopic retrograde cholangiopancreatography versus conservative treatment for acute pancreatitis due to gallstones. Lancet 2:979–983
Steinberg WM (1990) Predictors of severity of acute pancreatitis. Gastroenterol Clin N Am 19:849–861
Ranson JHC, Spencer FC (1978) The role of peritoneal lavage in severe acute pancreatitis. Ann Surg 187:565–575
Loiudice TA, Lang J, Mehta H, Banta L (1984) Treatment of acute alcoholic pancreatitis: the roles of Cimetidine and nasogastric suction. Am J Gastroenterol 79:553–558
Sarr MG, Sanfey H, Cameron JL (1986) Prospective randomized trial of nasogastric suction in patients with acute pancreatitis. Surgery 100:500–504
Bradley EL III, Hall JR, Lutz J, Hamner L, Lattouf O (1983) Hemodynamic consequences of severe pancreatitis. Ann Surg 198:130–133
Niederau C, Crass RA, Silver G, Ferrell LD, Grendell JH (1988) Therapeutic regimens in acute experimental hemorrhagic pancreatitis. Effects of hydration, oxygenation, peritoneal lavage, and a potent protease inhibitor. Gastroenterology 95:1648–1657
Driks MR, Craven DE, Celli BR, Manning M, Burke RA, Garvin GM, Kunches LM, Farber HW, Wedel SA, McCabe WR (1987) Nosocomial pneumonia in intubated patients given sucralfate as compared with antacids or histamine type 2 blockers. The role of gastric colonization. N Engl J Med 317:1376–1382
Tryba M (1985) Risk of acute stress bleeding and nosocomial pneumonia in ventilated intensive care unit patients: sucralfate versus antacids. Am J Med 83 [Suppl 3B]:117–124
Kalfarentzos FE, Karavias DD, Karatzas TM, Alevizatos BA, Androulakis JA (1991) Total parenteral nutrition in severe acute pancreatitis. J Am Coll Nutr 10:156–162
Latifi R, Mcintosh JK, Dudrick SJ (1991) Nutritional management of acute and chronic pancreatitis. Surg Clin N Am 71:579–595
Goodgame JT, Fischer JE (1987) Parenteral nutrition in the treatment of acute pancreatitis: effect on complications and mortality. Ann Surg 186:651–658
Howes R, Zuidema GD, Cameron JL (1975) Evaluation of prophylactic antibiotics in acute pancreatitis. J Surg Res 18:197–200
Finch WT, Sawyers JL, Schenker S (1976) A prospective study to determine the efficacy of antibiotics in acute pancreatitis. Ann Surg 183:667–671
Jeffrey RB Jr, Grendell JH, Federle MP, Meyer AA, Wing VW, Wall SD, Shea WJ (1987) Improved survival with early CT diagnosis of pancreatic abscess. Gastrointest Radiol 12:26–30
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
Medical Research Council Multicentre Trial (1980) Morbidity of acute pancreatitis. The effect of aprotinin and glucagon. Gut 21:334–349
Büchler M, Malfertheiner P, Uhl W, Stockmann F, Schölmerich J, Adler G, Rolle K, Ditschuneit H, Beger HG (1990) The German multicenter double blind randomized study of gabexate-mesilate (4g/day i.v.) in acute pancreatitis. Gastroenterology 98:A124 (Abstract)
Niederau C, Niederau M, Lüthen R, Strohmeyer G, Ferrell LD, Grendell JH (1990) Pancreatic exocrine secretion in acute experimental pancreatitis. Gastroenterology 99:1120–1127
Mitchell CJ, Playforth M, Kelleher J, McMahon MJ (1983) Functional recovery of the exocrine pancreas after acute pancreatitis. Scand J Gastreonterol 18:5–8
Grendell JH, Egan J (1987) Acute pancreatitis. West J Med 146:598–602
Forsmark CE, Grendell JH (1991) Complications of pancreatitis. Seminars in Gastrointestinal Disease 2:165–170
Beger HG, Büchler M, Bittner R, Oettinger W, Block S, Nevalainen T (1988) Necrosectomy and postoperative local lavage in patients with necrotizing pancreatitis: results of a prospective clinical trial. World J Surg 12:255–262
Bradley EL III, Allen K (1991) A prospective longitudinal study of observation versus surgical intenvention in the management of necrotizing pancreatitis. Am J Surg 161:19–25
Rutledge PL, Warshaw AL (1988) Persistent acute pancreatitis. A variant treated by pancreatoduodenectomy. Arch Surg 123:597–600
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
Grendell, J.H. (1993). Conservative Treatment of Acute Pancreatitis. 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_13
Download citation
DOI: https://doi.org/10.1007/978-3-642-77437-9_13
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-77439-3
Online ISBN: 978-3-642-77437-9
eBook Packages: Springer Book Archive