Diagnosis and Contemporary Management of Necrotizing Pancreatitis

Abstract

Background Acute pancreatitis is a common diagnosis which requires a prompt diagnosis and management by a multidisciplinary team with often general surgeons as the initial provider. Morbidity and mortality from an acute pancreatitis can be very high, especially in patients with a progressive worsening acute pancreatitis developing into pancreatic necrosis in the setting of multiple underlying medical comorbidities. Purpose In this review paper, we discuss all aspects of acute pancreatitis and its potential complications, as well providing updates in the modern management of necrotizing pancreatitis. Practicing general surgeons need to be aware of the evolution in the diagnosis and treatment of this disease. Research Design We conducted a review of literature of evidence and management options for acute pancreatitis, including all published manuscripts from 2012 to 2022. Results Diagnosis and management of this disease can vary among specialiaties. The decision to utilize a percutaneous or endoscopic techniques are relevant points of discussion within general surgery and gastroenterology societies. In the past decade, the use of advanced endoscopic interventions has slowly replaced conventional open surgery in managing complications of acute severe pancreatitis. Conclusion Acute pancreatitis is a disease which requires multidisciplinary approach with evolving treatment options to less invasive nonsurgical methods.

Contemporary management of acute pancreatitis: What you need to know

“…This ultimately leads to a significant inflammatory response potentially both within the pancreatic parenchyma and systemically. 1,11 To provide a common language in management of pancreatitis, the level of localized pancreatic parenchymal injury can be characterized both by the Revised Atlanta Criteria (RAC) 1,6,7,11,12 and also, more recently, by the American Association for the Surgery of Trauma (AAST) anatomic severity grading system. 13 Importantly, both systems are agnostic to the cause of pancreatitis.…”