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Part of the book series: Yearbook of Intensive Care and Emergency Medicine ((YEARBOOK,volume 1997))

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Abstract

Acute inflammation of the pancreas produces a spectrum of symptoms which range from mild and self-limiting, to a severe disease which leads rapidly to multiple organ failure and death. In some patients, a treatable underlying cause may be identified whereas, in others, the insult must run its own course. Although mild, interstitial, edematous pancreatitis is more common, when the more severe acute necrotizing pancreatitis (ANP) occurs, it is associated with a mortality of between 27–45% [1, 2]. Management of patients with severe ANP is time consuming, labor intensive, and requires extraordinary resources [3]. Despite this, long-term follow-up of such patients shows a good quality of life for patients who do survive this devastating illness [4].

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References

  1. Beger HG, Bittner R, Block S, Buchler M (1986) Bacterial contamination of pancreatic necrosis: A prospective clinical study. Gastroenterology 91: 433–438

    Google Scholar 

  2. Fernandez-Cruz L, Navarro S, Valderrama R, et al (1994) Acute necrotising pancreatitis: A multicenter study. Hepato-Gastroenterology 41: 185–189

    Google Scholar 

  3. Henderson A, Miller BJ, Wright M (1993) The resource implications of severe necrotising pancreatitis treated by necrosectomy. Aust NZJ Surg 63: 541–545

    Article  CAS  Google Scholar 

  4. Broome AH, Eisen GM, Harland RC, et al (1996) Quality of life after treatment for pancreatitis. Ann Surg 223: 665–670

    Article  PubMed  CAS  Google Scholar 

  5. Ranson JHC, Rifkind KM, Roses DF, et al (1974) Prognostic signs and the role of operative management in acute pancreatitis. Surg Gynaecol Obstet 139: 69–81

    CAS  Google Scholar 

  6. Blarney SL, Imrie CW, O’Neill J, et al (1984) Prognostic factors in acute pancreatitis. Gut 25: 1340–1346

    Article  Google Scholar 

  7. Malcynski JT, Iwanow IC, Burchard KW (1996) Severe pancreatitis: Determinants of mortality in a tertiary referral center. Arch Surg 131: 242–246

    Google Scholar 

  8. Bradley EL III (1992) A clinically based classification system for acute pancreatitis. Arch Surg 128: 586–590

    Article  Google Scholar 

  9. Balthazar E, Freeny P, van Sonnenberg E (1994) Imaging and intervention in acute pancreatitis. Radiology 193: 297–306

    PubMed  CAS  Google Scholar 

  10. Isenmann R, Buchler M, Uhl W, et al (1993) Pancreatic necrosis: An early finding in severe acute pancreatitis. Pancreas 8: 358–361

    Google Scholar 

  11. Balthazar E, Robinson D, Megibow A, Ranson J (1990) Acute pancreatitis: Value of CT in establishing prognosis. Radiology 174: 331–336

    Google Scholar 

  12. Kemppainen E, Sainio V, Haapianen L, et al (1996) Early localization of necrosis by contrast-enhanced computed tomography can predict outcome in severe acute pancreatitis. Br J Surg 83: 924–929

    Article  PubMed  CAS  Google Scholar 

  13. Geokas MC, Vanlacker JL, Kadell BM, Machleder HI (1972) Acute pancreatitis. Ann Intern Med 76: 105–112

    PubMed  CAS  Google Scholar 

  14. Martin JK, van Heerden JA, Bess MA (1984) Surgical management of acute pancreatitis. Mayo Clin Proc 59: 259–270

    Article  PubMed  Google Scholar 

  15. McFadden DW, Reber HA (1994) Indications for surgery in severe acute pancreatitis. Int J Pancreatol 15: 83–90

    PubMed  CAS  Google Scholar 

  16. Fan ST, Lai ECS, Mok FPT, et al (1993) Early treatment of acute biliary pancreatitis by endoscopic papillotomy. N Engl J Med 328: 228–233

    Article  PubMed  CAS  Google Scholar 

  17. Miller BJ, Henderson A, Strong RW, et al (1994) Necrotizing pancreatitis: Operating for life. World J Surg 18: 906–911

    Google Scholar 

  18. Poston GJ, Williamson RCN (1990) Surgical management of acute pancreatitis. Br J Surg 77: 5–10

    Article  PubMed  CAS  Google Scholar 

  19. Lee M, Ratner D, Legmate D, et al (1992) Acute complicated pancreatitis: Redefining the role of interventional radiology. Radiology 183: 171–174

    Google Scholar 

  20. Rau B, Pralle U, Uhl W, et al (1995) Management of sterile necrosis in instances of severe acute pancreatitis. J Am Col Surg 181: 279–288

    CAS  Google Scholar 

  21. Van Hagen PM, Krenning EP, Kwekkeboom DJ, et al (1994) Somatostatin and the immune and haematopoietic system: A review. Eur J Clin Invest 24: 91–99

    Google Scholar 

  22. Jenkins SA, Baxter JN, Day DW, et al (1986) The effects of somatostatin and SMN 201–995 on experimentally-induced pancreatitis and endotoxinemia in rats and on monocyte activity in patients with cirrhosis and portal hypertension. Klin Wochenschr 64 (Suppl 7): 100–106

    PubMed  CAS  Google Scholar 

  23. Kaplan O, Kaplan D, Casif E, et al (1996) Effects of delayed administration of octreotide in acute experimental pancreatitis. J Surg Res 62: 109–117

    Article  PubMed  CAS  Google Scholar 

  24. Friess H, Beger HG, Sulkowski U, et al (1995) Randomised controlled multicentre study of the prevention of complications by octreotide in patients undergoing surgery for chronic pancreatitis. Br J Surg 82: 1270–1273

    Article  PubMed  CAS  Google Scholar 

  25. Paran H, Neufeld D, Mayo A, et al (1995) Preliminary report of a prospective randomized study of octreotide in the treatment of severe acute pancreatitis. J Am Col Surg 181: 121–124

    CAS  Google Scholar 

  26. Fiedler F, Jauernig G, Keim V, et al (1996) Octreotide treatment in patients with necrotizing pancreatitis and pulmonary failure. Intensive Care Med 22: 909–915

    Article  PubMed  CAS  Google Scholar 

  27. Imrie CW, Benjamin IS, Ferguson JC, et al (1978) A single-centre, double-blind trial of trasylol therapy in primary acute pancreatitis. Br J Surg 65: 337–341

    Article  PubMed  CAS  Google Scholar 

  28. Buchler M, Malfertheiner P, Uhl W, et al (1992) Gabexate mesilate in human acute pancreatitis. Gastroenterology 104: 1165–1170

    Google Scholar 

  29. Howes R, Zuidema GD, Cameron JL (1975) Evaluation of prophylactic antibiotics in acute pancreatitis. J Surg Res 18: 197–200

    Article  PubMed  CAS  Google Scholar 

  30. Foitzik T, Castillo CF, Ferraro MJ, et al (1995) Pathogenesis and prevention of early infection in experimental acute necrotising pancreatitis. Ann Surg 222: 179–185

    Article  PubMed  CAS  Google Scholar 

  31. Mithofer K, Castillo CF, Ferraro MJ, et al (1996) Antibiotic treatment improves survival in experimental acute necrotizing pancreatitis. Gastroenterology 110: 232–240

    Article  PubMed  CAS  Google Scholar 

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

    CAS  Google Scholar 

  33. Sainio V, Kemppainen E, Puolakkainen P, et al (1995) Early antibiotic treatment in acute necrotizing pancreatitis. Lancet 346: 663–667

    Article  PubMed  CAS  Google Scholar 

  34. Banerjee A (1995) Antibiotics, free radicals, and acute pancreatitis. Lancet 346: 972 (Letter)

    Google Scholar 

  35. Marulendra S, Kirby DF (1995) Nutritional support in pancreatitis. Nutr Clin Pract 10: 45–53

    Article  PubMed  CAS  Google Scholar 

  36. Kudsk KA, Croce MA, Fabian TC, et al (1992) Enteral versus parenteral feeding: Effects on septic morbidity following blunt and penetrating abdominal trauma. Ann Surg 215: 503–513

    Google Scholar 

  37. Moore FA, Moore EE, Jones TN, et al (1989) TEN versus TPN following major abdominal trauma—Reduced septic morbidity. J Trauma 29: 916–924

    Article  PubMed  CAS  Google Scholar 

  38. Moore FA, Feliciano DV, Andrassy RJ, et al (1992) Early enteral feeding, compared with parenteral, reduces postoperative septic complications–The results of a meta-analysis. Ann Surg 216: 62–69

    Article  Google Scholar 

  39. Pomposelli JJ, Bistrian BR (1994) Is total parenteral nutrition immunosuppressive? New Horizons 2: 224–229

    PubMed  CAS  Google Scholar 

  40. Brennan MF, Pisters PW, Posner M, et al (1994) A prospective randomized trial of total parenter-al nutrition after major pancreatic resection for malignancy. Ann Surg 220: 436–441

    Article  PubMed  CAS  Google Scholar 

  41. Sitzmann JV, Steinborn PA, Zinner MJ, Cameron JL (1989) Total parenteral nutrition and alternate energy substrates in the treatment of severe acute pancreatitis. Surg Gynaecol Obstet 168: 311–317

    CAS  Google Scholar 

  42. Pisters PWT, Ranson JHC (1992) Nutritional support for acute pancreatitis. Surg Gynaecol Obstet 175: 275–284

    CAS  Google Scholar 

  43. Kudsk KA, Campbell SM, O’Brien T, et al (1990) Postoperative jejunal feedings following complicated pancreatitis. Nutr Clin Prac 5: 14–17

    Article  CAS  Google Scholar 

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© 1997 Springer-Verlag Berlin Heidelberg

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Wyncoll, D.L., Beale, R.J. (1997). Severe Acute Necrotizing Pancreatitis. In: Vincent, JL. (eds) Yearbook of Intensive Care and Emergency Medicine 1997. Yearbook of Intensive Care and Emergency Medicine, vol 1997. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-13450-4_57

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  • DOI: https://doi.org/10.1007/978-3-662-13450-4_57

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-13452-8

  • Online ISBN: 978-3-662-13450-4

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