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Surgical management of necrotizing pancreatitis:An overview 被引量:17
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作者 George Kokosis Alexander Perez theodore n pappas 《World Journal of Gastroenterology》 SCIE CAS 2014年第43期16106-16112,共7页
Necrotizing pancreatitis is an uncommon yet serious complication of acute pancreatitis with mortality rates reported up to 15%that reach 30%in case of infection.Traditionally open surgical debridement was the only too... Necrotizing pancreatitis is an uncommon yet serious complication of acute pancreatitis with mortality rates reported up to 15%that reach 30%in case of infection.Traditionally open surgical debridement was the only tool in our disposal to manage this serious clinical entity.This approach is however associated with poor outcomes.Management has now shifted away from open surgical debridement to a more conservative management and minimally invasive approaches.Contemporary approach to patients with necrotizing pancreatitis and/or infectious pancreatitis is summarized in the 3Ds:Delay,Drain and Debride.Patients can be managed in the intensive care unit and any intervention should be delayed.Percutaneous drainage can be utilized first and early in the course of the disease,followed by endoscopic drainage or video assisted retroperitoneoscopic drainage if necrosectomy is deemed necessary.Open surgery is now less frequently performed and should be reserved for cases refractory to any other approach.The management of necrotizing pancreatitis therefore requires a multidisciplinary dynamic model of approach rather than being a surgical disease. 展开更多
关键词 Necrotizing pancreatitis Severe acute pancreatitis DEBRIDEMENT NECROSECTOMY Infected necrosis Endoscopic necrosectomy Video-assisted retroperitoneal debridement Percutaneous catheter drainage
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