Surgical treatment of sterile necrosis in acute pancreatitis: Are patients with secondary pancreatic infections a distinct entity?

2001 ◽  
Vol 120 (5) ◽  
pp. A485-A485
Author(s):  
B RAU ◽  
W HOFFMANN ◽  
R ISENMANN ◽  
H BEGER
2001 ◽  
Vol 120 (5) ◽  
pp. A485
Author(s):  
Bettina Rau ◽  
Wolfgang Hoffmann ◽  
Reiner Isenmann ◽  
Hans G. Beger

2017 ◽  
Vol 49 ◽  
pp. e94
Author(s):  
L.G. Cavallaro ◽  
B. Germanà ◽  
A. Giacomin ◽  
A. Gabbrielli ◽  
L. Frulloni ◽  
...  

1999 ◽  
pp. 78-89 ◽  
Author(s):  
H. G. Beger ◽  
B. Rau ◽  
J. Mayer ◽  
R. Isenmann

2020 ◽  
pp. 16-18
Author(s):  
A. G. Drozdova

Summary. The aim of the study. To improve the results of surgical treatment of patients with acute pancreatitis using minimal invasive techniques. Matherials and Methods of the study. The results of surgical treatment of 75 patients with different forms of acute pancreatitis were analyzed. All patients were examined and operated on. Results of the study. Minimally invasive interventions were performed in 92 % of the analyzed patients. Intraoperatively acute pancreatic edema was observed in 43 % of patients, hemorrhagic pancreatic necrosis – in 24 %, infected pancreatic necrosis – in 33 %. The postoperative period was complicated by 13.3 %, the mortality rate was 9.3 %. Conclusions. The use of minimally invasive techniques for treating acute pancreatitis can significantly improve the results of surgical treatment of patients with this pathology. The frequency of complications and lethality decreases. Also, it is possible to significantly reduce operational trauma, and hence the number of bed-days of stay in hospital treatment. This contributes to reducing the financial cost of treatment in patients with acute pancreatitis, as well as improving the quality of life of this category of patients.


Pancreas ◽  
2007 ◽  
Vol 35 (1) ◽  
pp. 88-89
Author(s):  
Yoshifumi Takeyama ◽  
Yasuyuki Kihara ◽  
Makoto Otsuki

2003 ◽  
Vol 6 (5) ◽  
pp. 359-367 ◽  
Author(s):  
Jens Werner ◽  
Waldemar Uhl ◽  
Markus W. Büchler

2015 ◽  
Vol 87 (10) ◽  
Author(s):  
Stanisław Głuszek ◽  
Łukasz Nawacki ◽  
Jarosław Matykiewicz ◽  
Marta Kot ◽  
Jakub Kuchinka

AbstractAcute pancreatitis (AP) develops as a result of the imbalance of the mechanisms inhibiting the activity of enzymes in the pancreatic cells, which causes their autoactivation in the pancreas. The incidence of AP ranges from 10 up to 100 cases per 100,000 population per year in different parts of the world. The overall mortality rate for acute pancreatitis is 10-15%. The mortality rate in patients diagnosed with the severe form of acute pancreatitis is up to 30-40%.The study included 10 patients treated due to acute pancreatitis in two surgical departments run by one of the authors (S.G.) in the years 2004-2014, who developed a serious complication in the form of haemorrhage into the inflammatory tumour/pancreatic cyst or an adjacent organ. Haemorrhage was diagnosed based on the clinical picture, most often a sudden drop in blood pressure, peritonitis symptoms and imaging findings – abdominal ultrasound and abdominal computed tomography. Therapeutic methods included conservative treatment, endovascular embolisation and, in the absence of efficacy of the above mentioned methods, surgical treatment. Patients age and gender, the etiological factor, comorbidities, Atlanta Classification, treatment outcomes and mortality rate were assessed.Alcohol was the most common etiological factor in the investigated AP cases. The patients received conservative treatment, interventional radiology treatment (endovascular embolisation) or surgical treatment. In the study group, 6 patients required surgical treatment, 3 patients received invasive radiology treatment, and conservative treatment was used in one patient. The mortality rate in the study group was 30%.Haemorrhages into the inflammatory cisterns or adjacent organs (stomach, transverse colon mesentery) secondary to AP are the most severe complications, which are difficult to manage. The successful use of interventional radiology methods to inhibit and prevent the recurrence of bleeding in some of the patients is a significant milestone.


2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Ahmad H m Nassar ◽  
Rhona Kilpatrick ◽  
Mahmoud Sallam ◽  
Kiren Ali

Abstract Background There is increasing evidence that single session laparoscopic cholecystectomy with cholangiography and, when necessary and available, bile duct exploration offers optimal clinical outcomes and superior cost benefits to patients with suspected bile duct stones. There is a perception that preoperative endoscopic clearance of bile duct stones is necessary in patients presenting with pancreatitis and jaundice. However, most patients do not have severe disease and are fit for index admission surgical management. We aim to study the prevalence of bile duct stones in pancreatitis vs. jaundice and evaluate this management approach with regards to preoperative and operative parameters and postoperative outcomes. Methods Analysis of prospectively maintained database of 5774 consecutive laparoscopic cholecystectomies, cholangiography(IOC) with or without bile duct exploration was undertaken. Patients with suspected bile duct stones are referred to one firm with an intention of single surgical treatment in the index admission. Data of patients presenting with acute pancreatitis and obstructive jaundice was extracted. In the absence of suspected malignancy there was a limited role for preoperative MRCP and ERCP. The incidence of confirmed CBD stones requiring exploration, type of exploration, morbidity, re-operations and readmissions, hospital stay, number of episodes, and presentation to resolution intervals were compared in the two groups. Results Conclusions Single session surgical treatment of patients with acute pancreatitis and jaundice by specialist firms in the index admission (89% and 86% if previous admissions by other units is excluded) offers many advantages. MRCP and ERCP utilisation is minimised in favour of IOC; two thirds of pancreatitis patients and one third of jaundiced patients have no CBD stones. Simple transcystic explorations deals with most stones in both groups. The morbidity, open conversion, readmissions, retained stones and re-operations are low. Total hospital stay, number of treatment episodes and presentation to resolution are optimised and should persuade surgeons to avoid subjecting patients to multiple treatments.


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