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Surgical Treatment of Pancreatic Diseases pp 83–94Cite as

Medical Management of Acute Pancreatitis

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Part of the book series: Updates in Surgery ((UPDATESSURG))

Abstract

All cases of mild acute pancreatitis (AP) and the majority of the severe forms of the disease are treated conservatively. Medical therapy is therefore of fundamental importance in the management of this disease. However, apart from the common devices of cardiovascular and respiratory support, thanks to which the early mortality in severe AP has been greatly reduced, to this day we do not have a specific and effective drug capable of acting on the physiopathology of the disease and of leading to a positive outcome. Antibiotic prophylaxis, equally a cornerstone of medical therapy, has for the past few years come under critical scrutiny.

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References

  1. Feldman M, Friedman LS, Sleisenger MH (2004) Malattie dell’apparato gastrointestinale e del fegato: pancreas-vie biliari. Excerpta Medica, Milano

    Google Scholar 

  2. Frossard JL, Steer ML, Pastor CM (2008) Acute pancreatitis. Lancet 371 (9618):143–152

    Article  PubMed  Google Scholar 

  3. Sabiston (2003) Trattato di chirurgia: le basi biologiche della moderna pratica chirurgica. (1st italian edn, 16th American edn). Antonio Delfino Editore, Roma

    Google Scholar 

  4. Chipman JG (2005) Acute pancreatitis in the surgical intensive care unit. In: Abrams JH, Druck P, Cerra FB (eds) Surgical critical care, 2nd edn. Taylor & Francis, London

    Google Scholar 

  5. Hayden P, Wyncoll D (2008) Severe acute pancreatitis. Curr Anaesth Crit Care 19:1

    Article  Google Scholar 

  6. Whang EE (2006) Acute pancreatitis. In: Mulholland MW, Lillemoe KD, Doherty GM et al (eds) Greenfield’s surgery: Scientific principles and practice, 4th edn. Lippincott Williams & Wilkins, Philadelphia

    Google Scholar 

  7. Caronna R, Diana L, Nofroni I et al (2005) Effects of gabexate mesilate (FOY) on amylase and phospholipase A2 in human serum and pancreatic juice. Dig Dis Sci 50:868–873

    Article  CAS  PubMed  Google Scholar 

  8. Uhl W, Büchler MW, Malfertheiner P et al (1999) A randomized, double blind, multicentre trial of octreotide in moderate to severe acute pancreatitis. Gut 45:97–104

    Article  CAS  PubMed  Google Scholar 

  9. Heinrich S, Schäfer M, Rousson V, Clavien PA (2006) Evidence-based treatment of acute pancreatitis. A look at established paradigms. Ann Surg 243:154–168

    Article  PubMed  Google Scholar 

  10. Paran H, Mayo A, Paran D et al (2000) Octreotide treatment in patients with severe acute pancreatitis. Dig Dis Sci 45:2247–2251

    Article  CAS  PubMed  Google Scholar 

  11. Andriulli A, Leandro G, Clemente R et al (1998) Meta-analysis of somatostatin, octreotide and gabexate mesilate in the therapy of acute pancreatitis. Aliment Pharmacol Ther 12:237–245

    Article  CAS  PubMed  Google Scholar 

  12. Pederzoli P, Cavallini G, Falconi M, Bassi C (1993) Gabexate mesilate vs aprotinin in human acute pancreatitis (GA.ME.P.A.). A prospective, randomized, double blind, multicentre study. Int J Pancreatol 14:117–124

    CAS  PubMed  Google Scholar 

  13. Chen HM, Chen JC, Hwang TL et al (2000) Prospective and randomized study of gabexate mesilate for the treatment of severe acute pancreatitis with organ dysfunction. Hepatogastroenterology 47:1147–1150

    CAS  PubMed  Google Scholar 

  14. Pezzilli R, Miglioli M (2001) Multicentre comparative study of two schedules of gabexate mesilate treatment of acute pancreatitis. Italian Acute Pancreatitis Study Group. Dig Liver Dis 33:49–57

    CAS  Google Scholar 

  15. Messori A, Rampazzo R, Scroccaro G et al (1995) Effectiveness of gabexate mesilate in acute pancreatitis. A meta-analysis. Dig Dis Sci 40:734–738

    Article  CAS  PubMed  Google Scholar 

  16. Banfi R, Borselli G, Cappelletti S et al (2005) Gabexate mesilate and acute pancreatitis: an experience of evidence based drug information for improving rational drug use. Pharm World Sci 27:121–123

    Article  CAS  PubMed  Google Scholar 

  17. Nathens AB, Curtis JR, Beale RJ et al (2004) Management of the critically ill patient with severe acute pancreatitis. Crit Care Med 32:2524–2535

    Article  PubMed  Google Scholar 

  18. Schein M (2005) Acute pancreatitis. In: Schein’s common sense emergency abdominal surgery. Springer, Berlin Heidelberg New York

    Chapter  Google Scholar 

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

    Article  Google Scholar 

  20. Delcensire R, Yzet T, Ducroix JP et al (1996) Prophylactic antibiotics in treatment of severe acute alcoholic pancreatitis. Pancreas 13:198–201

    Google Scholar 

  21. Shwarz M, Isenmann R, Meyer H et al (1997) Antibiotic use in necrotizing pancreatitis: results of a controlled study. Dtsh Med Wochenschr 122:356–361

    Article  Google Scholar 

  22. Pederzoli P, Bassi S, Vesentini S et al (1993) A randomized multicenter clinical trial of antibiotic prophylaxis of septic complications in acute necrotizing pancreatitis with imipenem. Surg Gynecol Obstet 176:480–483

    CAS  PubMed  Google Scholar 

  23. Nordback I, Sand J, Saaristo R et al (2001) Early treatment with antibiotics reduces the need for surgery in acute necrotizing pancreatitis: a single-center randomized study. J Gastrointest Surg 5:113–119

    Article  CAS  PubMed  Google Scholar 

  24. Bassi C, Falconi M, Talamini G et al (1998) A controlled clinical trial of pefloxacin versus imipenem in severe acute pancreatitis. Gastroenterology 115:1513–1517

    Article  CAS  PubMed  Google Scholar 

  25. Manes G, Rabitti PG, Menchise A et al (2003) Prophylaxis with meropenem of septic complications in acute pancreatitis: a randomized, controlled trial versus imipenem. Pancreas 27:79–83

    Article  Google Scholar 

  26. Manes G, Uomo I, Menchise A et al (2006) Timing of antibiotic prophylaxis in acute pancreatitis: a controlled randomized study with meropenem. Am J Gastroenterol 101:1348–1353

    Article  CAS  PubMed  Google Scholar 

  27. Golub R, Siddiqi F, Pohl D (1998) Role of antibiotics in acute pancreatitis: a meta-analysis. J Gastrointest Surg 2:496–503

    Article  CAS  PubMed  Google Scholar 

  28. Bassi C, Larvin M, Villatoro E (2003) Antibiotic therapy for prophylaxis against infection of pancreatic necrosis in acute pancreatitis. Cochrane Database Syst Rev 4:CD002941

    PubMed  Google Scholar 

  29. Sharma VK, Howden CW (2001) Prophylactic antibiotic administration reduces sepsis and mortality in acute necrotizing pancreatitis: a meta-analysis. Pancreas 22:28–31

    Article  CAS  PubMed  Google Scholar 

  30. Zhou YM, Xue ZL, Li Ym et al (2005) Antibiotic prophylaxis in patients with severe acute pancreatitis. Hepatobiliary Pancreat Dis Int 4:23–27

    CAS  PubMed  Google Scholar 

  31. Villatoro E, Bassi C, Larvin M (2006) Antibiotic therapy for prophylaxis against infection of pancreatic necrosis in acute pancreatitis. Cochrane Database Syst Rev 4:CD002941

    PubMed  Google Scholar 

  32. Isenmann R, Runzi M, Kron M (2004) Prophylactic antibiotic treatment in patients with predicted severe acute pancreatitis: a placebo-controlled, double blind trial. Gastroenterology 126:997–1004

    Article  CAS  PubMed  Google Scholar 

  33. Dellinger EP, Tellado JM, Soto NE et al (2007) Early antibiotic treatment for severe acute necrotizing pancreatitis: a randomized, double blind, placebocontrolled study. Ann Surg 245:674–683

    Article  PubMed  Google Scholar 

  34. Luiten EJT, Hop WCJ, Lange JF et al (1995) Controlled clinical trial of selective decontamination for the treatment of severe acute pancreatitis. Ann Surg 222:57–65

    Article  CAS  PubMed  Google Scholar 

  35. De Waele JJ, Vogelaers D, Blot S et al (2003) Fungal infections in patients with severe acute pancreatitis and the use of prophylactic therapy. Clin Infect Dis 37:208–213

    Article  PubMed  Google Scholar 

  36. Grewe M, Tsiotos GG, Luque de Leon E et al (1999) Fungal infection in acute necrotizing pancreatitis. J Am Coll Surg 188:408–414

    Article  CAS  PubMed  Google Scholar 

  37. He YM, Lu XS, Ai ZL et al (2003) Prevention and therapy of fungal infection in severe acute pancreatitis: a prospective clinical study. World J Gastroenterol 9:2619–2621

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of General Surgery, A. Murri Hospital, Fermo (AP), Italy

    Marco Romiti, Luciano Minestroni & Gabriele Corradini

  2. Department of Surgery, Ospedali Riuniti University Hospital, Polytechnic University of Marche, Ancona, Italy

    Walter Siquini

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  1. Marco Romiti
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  2. Luciano Minestroni
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  3. Walter Siquini
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  4. Gabriele Corradini
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© 2009 Springer-Verlag Italia

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Romiti, M., Minestroni, L., Siquini, W., Corradini, G. (2009). Medical Management of Acute Pancreatitis. In: Surgical Treatment of Pancreatic Diseases. Updates in Surgery. Springer, Milano. https://doi.org/10.1007/978-88-470-0856-4_6

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  • DOI: https://doi.org/10.1007/978-88-470-0856-4_6

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-0855-7

  • Online ISBN: 978-88-470-0856-4

  • eBook Packages: MedicineMedicine (R0)

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