Inhibitors of Pancreatic Secretion and Antiproteases in Acute Pancreatitis and Pancreatic Surgery
Acute pancreatitis is a common and potentially life-threatening condition that requires a multidisciplinary team for diagnosis and correct treatment . Although it is one of the most studied conditions in the history of medicine, acute pancreatitis still remains a demanding and dreadful disease. It may be considered as self-digestion of the pancreas, and progress in recent years in our understanding of the pathophysiology has led to some improvement in the diagnosis and outcome for patients suffering from the severe form of the disease [2, 3, 4]. Usually the pancreatic enzymes, in the form of proenzymes, are transported from pancreatic ducts in the duodenum, where they are activated. In acute pancreatitis there is early activation of intracellular zymogens with a complex phenomenon that leads to inflammation and tissue damage . The severe course of the disease is characterized by a systemic inflammatory response that can induce multiorgan failure. Comprehension of this early activation of proenzymes represents the basis from which to understand the disease and develop its treatment [5, 6]. In the assessment of therapy we believe it is essential to distinguish between the acute phase, treatment of the causal factor, and the prevention of pancreatic fistula after surgical resection. This last aspect will form the final part of this chapter.
KeywordsAcute Pancreatitis Chronic Pancreatitis Pancreatic Fistula Severe Acute Pancreatitis Pancreatic Secretion
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