Updates in the Management of Acute Pancreatitis

Published on Jan 1, 2019
· DOI :10.1007/978-3-319-95114-0_30
Giampaolo Perri8
Estimated H-index: 8
,
Giovanni Marchegiani , Claudio Bassi3
Estimated H-index: 3
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Abstract
This chapter reviews the current state of the art of clinical management in acute pancreatitis, a disease that continues to be a leading gastrointestinal cause of hospitalization and severe morbidity and mortality.
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References51
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Currently, both the step-up approach, combining percutaneous drainage (PD) and video-assisted retroperitoneal debridement (VARD), and endoscopic transgastric necrosectomy (ETN) are mini-invasive techniques for infected necrosis in severe acute pancreatitis. A combination of these approaches could maximize the management of necrotizing pancreatitis, conjugating the benefits from both the experiences. However, reporting of this combined strategy is anecdotal. This is the first reported case of sev...
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#1David W da CostaH-Index: 9
#2Stefan A.W. Bouwense (Radboud University Nijmegen)H-Index: 26
Last. Djamila BoermaH-Index: 32
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Summary Background In patients with mild gallstone pancreatitis, cholecystectomy during the same hospital admission might reduce the risk of recurrent gallstone-related complications, compared with the more commonly used strategy of interval cholecystectomy. However, evidence to support same-admission cholecystectomy is poor, and concerns exist about an increased risk of cholecystectomy-related complications with this approach. In this study, we aimed to compare same-admission and interval chole...
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#1Ilias P. Gomatos (University of Liverpool)H-Index: 6
#2Xu Xiaodong (University of Liverpool)H-Index: 1
Last. John P. Neoptolemos (University of Liverpool)H-Index: 127
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Acute pancreatitis has a mortality rate of 5–10%. Early deaths are mainly due to multiorgan failure and late deaths are due to septic complications from pancreatic necrosis. The recently described 2012 Revised Atlanta Classification and the Determinant Classification both provide a more accurate description of edematous and necrotizing pancreatitis and local complications. The 2012 Revised Atlanta Classification uses the modified Marshall scoring system for assessing organ dysfunction. The Deter...
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#1Simon Gibson (Glasgow Royal Infirmary)H-Index: 4
#2Bernard F. Robertson (Glasgow Royal Infirmary)H-Index: 4
Last. C. Ross Carter (Glasgow Royal Infirmary)H-Index: 20
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Background: Post-acute pancreatic collections (PAPCs) may require intervention when persistent, large or symptomatic. An open cystgastrostomy is an effective treatment option particularly for larger, solid predominant collections. A laparoscopic cystgastrostomy (LCG) as initially described, could be technically challenging. This report describes the evolution of the operative technique and the results from LCG in a tertiary referral centre. Methods: Retrospective analysis of the unit’s prospecti...
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#1Sandra van Brunschot (UvA: University of Amsterdam)H-Index: 14
#2Janneke van Grinsven (UvA: University of Amsterdam)H-Index: 11
Last. Paul Fockens (UvA: University of Amsterdam)H-Index: 99
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Background Infected necrotising pancreatitis is a potentially lethal disease that nearly always requires intervention. Traditionally, primary open necrosectomy has been the treatment of choice. In recent years, the surgical step-up approach, consisting of percutaneous catheter drainage followed, if necessary, by (minimally invasive) surgical necrosectomy has become the standard of care. A promising minimally invasive alternative is the endoscopic transluminal step-up approach. This approach cons...
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#2David Rigau ComasH-Index: 3
Last. Gerard Urrútia (Cochrane Collaboration)H-Index: 26
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Background Acute pancreatitis is an acute inflammatory process of the pancreas that may also involve adjacent tissues and/or remote organ systems. Abdominal pain is the main symptom and is usually accompanied by nausea, vomiting and fever. Opoids are commonly used to manage pain in acute pancreatitis but there are still some uncertainties about their clinical effectiveness and safety. Objectives To assess the effectiveness and safety of opioids for treating acute pancreatitis pain. Search method...
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#1Andrew W. Kirkpatrick (FMC: Foothills Medical Centre)H-Index: 78
#2Derek J. Roberts (U of C: University of Calgary)H-Index: 38
Last. Janeth C. Ejike (LLU: Loma Linda University)H-Index: 8
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Purpose To update the World Society of the Abdominal Compartment Syndrome (WSACS) consensus definitions and management statements relating to intra-abdominal hypertension (IAH) and the abdominal compartment syndrome (ACS).
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BACKGROUND: There have been substantial improvements in the management of acute pancreatitis since the publication of the International Association of Pancreatology (IAP) treatment guidelines in 2002. A collaboration of the IAP and the American Pancreatic Association (APA) was undertaken to revise these guidelines using an evidence-based approach. METHODS: Twelve multidisciplinary review groups performed systematic literature reviews to answer 38 predefined clinical questions. Recommendations we...
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#1Peter A. Banks (Brigham and Women's Hospital)H-Index: 76
#2Thomas L. BollenH-Index: 44
Last. Santhi Swaroop Vege (Mayo Clinic)H-Index: 52
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Background and objective The Atlanta classification of acute pancreatitis enabled standardised reporting of research and aided communication between clinicians. Deficiencies identified and improved understanding of the disease make a revision necessary. Methods A web-based consultation was undertaken in 2007 to ensure wide participation of pancreatologists. After an initial meeting, the Working Group sent a draft document to 11 national and international pancreatic associations. This working dra...
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Background & Aims Gastrointestinal (GI) diseases account for substantial morbidity, mortality, and cost. Statistical analyses of the most recent data are necessary to guide GI research, education, and clinical practice. We estimate the burden of GI disease in the United States. Methods We collected information on the epidemiology of GI diseases (including cancers) and symptoms, along with data on resource utilization, quality of life, impairments to work and activity, morbidity, and mortality. T...
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