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Management of Pancreatic Necrosis and Abscess

  • Conference paper
Standards in Pancreatic Surgery

Abstract

The treatment of acute pancreatitis is primarily supportive. Management of severe pancreatitis entails evaluation of multiple clinical, radiologic, and biochemical parameters to determine the timing and type of intervention when it becomes necessary to alter the natural course of the disease. Recent work by Beger and others [1–4] has emphasized that when pancreatitis is complicated by the development of necrosis, infection is the primary determinant of outcome. Others have therefore extrapolated that the presence or absence of infection should determine whether or not surgical intervention is undertaken [3, 4]. Minimally invasive therapy (such as diagnostic needle aspiration) or observation alone have been advocated for sterile necrosis [3, 4]. Furthermore, the successful experience with percutaneous radiologically guided drainage of abdominal abscesses [5, 6] has brought enthusiasm for this technique to the treatment of pancreatic sepsis [7, 8]. Amid these trends we chose to examine the experience at our institution with cases of severe necrotizing pancreatitis during the past 5 years.

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Author information

Authors and Affiliations

  1. Department of Surgery, Massachusetts General Hospital and Harvard Medical School, 02114, Boston, MA, USA

    D. W. Rattner

Authors
  1. D. W. Rattner
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  2. A. L. Warshaw
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Editor information

Editors and Affiliations

  1. Abteilung für Allgemeine Chirurgie, Universitätsklinik Ulm, Steinhövelstraße 9, W-7900, Ulm, Germany

    H. G. Beger  & M. Büchler  & 

  2. Abteilung Innere Medizin II, Universitätsklinik Ulm, Robert-Koch-Straße 8, W-7900, Ulm, Germany

    P. Malfertheiner

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© 1993 Springer-Verlag Berlin Heidelberg

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Rattner, D.W., Warshaw, A.L. (1993). Management of Pancreatic Necrosis and Abscess. 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_28

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  • DOI: https://doi.org/10.1007/978-3-642-77437-9_28

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-77439-3

  • Online ISBN: 978-3-642-77437-9

  • eBook Packages: Springer Book Archive

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