Abstract
Despite that pancreatic necrosis complicates only 15 % of cases of acute pancreatitis (AP), it is associated with high morbidity and considerable mortality. In an attempt to improve prognosis, many surgical strategies have been described during the last few decades. Currently, necrosectomy remains the cornerstone in the surgical treatment of infected pancreatic necrosis and in selected cases of sterile necrotizing pancreatitis. Following necrosectomy, continuous closed lavage is recommended by many authors, while closed abdominal packing /drainage and repeated planned necrosectomies- commonly using the zipper technique-are also acceptable alternative strategies. Open abdomen (laparostomy) is rarely indicated in carefully selected cases (typically in abdominal compartment syndrome associated with necrotizing AP). During the last decade, minimally invasive techniques (including percutaneous drainage, retroperitoneal endoscopic approach, transgastric endoscopic approach etc) have been extensively studied by some groups not only in the management of pancreatic abscesses and / or pseudocysts, but also as primary methods of treatment of necrotizing AP. Results have been impressive, but experience currently is limited to only a few centers around the world.
Keywords: Pancreatitis, surgery, necrosectomy, laparoscopic, endoscopic, pancreas, lavage
Infectious Disorders - Drug Targets
Title:Necrotizing Acute Pancreatitis Current Status - Emerging New Strategies in Surgical Management
Volume: 12 Issue: 2
Author(s): George H. Sakorafas, Dimitrios Sampanis, Christos Lappas, Panayiotis Kokoropoulos, Aikaterini Mastoraki and Vassilios Smyrniotis
Affiliation:
Keywords: Pancreatitis, surgery, necrosectomy, laparoscopic, endoscopic, pancreas, lavage
Abstract: Despite that pancreatic necrosis complicates only 15 % of cases of acute pancreatitis (AP), it is associated with high morbidity and considerable mortality. In an attempt to improve prognosis, many surgical strategies have been described during the last few decades. Currently, necrosectomy remains the cornerstone in the surgical treatment of infected pancreatic necrosis and in selected cases of sterile necrotizing pancreatitis. Following necrosectomy, continuous closed lavage is recommended by many authors, while closed abdominal packing /drainage and repeated planned necrosectomies- commonly using the zipper technique-are also acceptable alternative strategies. Open abdomen (laparostomy) is rarely indicated in carefully selected cases (typically in abdominal compartment syndrome associated with necrotizing AP). During the last decade, minimally invasive techniques (including percutaneous drainage, retroperitoneal endoscopic approach, transgastric endoscopic approach etc) have been extensively studied by some groups not only in the management of pancreatic abscesses and / or pseudocysts, but also as primary methods of treatment of necrotizing AP. Results have been impressive, but experience currently is limited to only a few centers around the world.
Export Options
About this article
Cite this article as:
H. Sakorafas George, Sampanis Dimitrios, Lappas Christos, Kokoropoulos Panayiotis, Mastoraki Aikaterini and Smyrniotis Vassilios, Necrotizing Acute Pancreatitis Current Status - Emerging New Strategies in Surgical Management, Infectious Disorders - Drug Targets 2012; 12 (2) . https://dx.doi.org/10.2174/187152612800100107
DOI https://dx.doi.org/10.2174/187152612800100107 |
Print ISSN 1871-5265 |
Publisher Name Bentham Science Publisher |
Online ISSN 2212-3989 |
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Losartan Chemistry and Its Effects via AT1 Mechanisms in the Kidney
Current Medicinal Chemistry Progressive Supranuclear Palsy: What Do We Know About it?
Current Medicinal Chemistry Amyloid Precursor Protein Processing in Vivo - Insights from a Chemically- Induced Constitutive Overactivation of Protein Kinase C in Guinea Pig Brain
Current Medicinal Chemistry The Discovery of the Factor Xa Inhibitor Otamixaban: From Lead Identification to Clinical Development
Current Medicinal Chemistry SARS Coronavirus Anti-Infectives
Recent Patents on Anti-Infective Drug Discovery Gene Therapy in the Anterior Eye Segment
Current Gene Therapy The Multidomain Mobility Lab in Older Persons: From Bench to Bedside. The Assessment of Body Composition in Older Persons at Risk of Mobility Limitations
Current Pharmaceutical Design Endocrine Disruptors and Human Health
Mini-Reviews in Medicinal Chemistry Dynamics of Virus-Host Interplay in HIV-1 Replication
Current HIV Research Extracellular Hsp70: Export and Function
Current Protein & Peptide Science Cathepsin K Inhibitors: A Novel Target but Promising Approach in the Treatment of Osteoporosis
Current Drug Targets New Strategies in the Chemotherapy of Leukemia: Eradicating Cancer Stem Cells in Chronic Myeloid Leukemia
Current Cancer Drug Targets Cell Immunity in Coronary Artery Disease (CAD)
Current Immunology Reviews (Discontinued) Management of Acute Aluminum Phosphide Poisoning: Has Anything Changed?
Drug Metabolism Letters Mitochondrial Serine Protease HtrA2/Omi as a Potential Therapeutic Target
Current Drug Targets Amyloid Forming Proteases: Therapeutic Targets for Alzheimers Disease
Current Pharmaceutical Design Peroxisome Proliferator-Activated Receptor-α Activation Protects Brain Capillary Endothelial Cells from Oxygen-Glucose Deprivation-Induced Hyperpermeability in the Blood-Brain Barrier
Current Neurovascular Research Therapeutic Approaches to the Challenge of Neuronal Ceroid Lipofuscinoses
Current Pharmaceutical Biotechnology Molecular Mechanisms Involved in the Aging of the T-cell Immune Response
Current Genomics Understanding the Multifaceted Role of Inflammatory Mediators in Ischemic Stroke
Current Medicinal Chemistry