Die Bedeutung eines klinischen Protokolls bei der Behandlung der schweren akuten Pankreatitis

Pupelis, Guntars; Austrums, Edmunds; Snippe, K.

doi:10.1055/s-2002-35761

Cited by 4 publications

(4 citation statements)

References 39 publications

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“…The mortality rate in AP is influenced by many factors with various degrees including age, etiology, the extent of necrosis, and presence of multi-organ failure [9-10]. Patients managed according to standard guidelines/protocols have shown better outcome in term of complications rate, length of hospital stay, morbidity and mortality [11].…”

Section: Discussionmentioning

confidence: 99%

“…There are many barriers which can lead to poor adherence to standard guidelines including physicians lack of knowledge and lack of clinical decision support tools. It has been shown that there were better clinical outcomes with increased adherence to guidelines after educating physicians and the introduction of clinical decision support tools in managing patients with AP [11-12]. It is very important that residents and physicians must have a good fund of knowledge about current guidelines for managing AP.…”

Section: Discussionmentioning

confidence: 99%

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The Assessment of Knowledge and Early Management of Acute Pancreatitis Among Residents

Mehmood¹,

Ullah²,

Chan³

et al. 2019

Cureus

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There has been a rapid increase in the incidence of acute pancreatitis (AP) and associated mortality. This mortality is even higher in patients having severe disease (about 30% in contrast to 10% in mild AP). Some of the factors which have proven to lower the mortality are early feeding rather than keeping patient nil per oral (NPO), and aggressive intravenous fluid replacement therapy, especially during the first 12-24 hours. in our study, we investigated the reasons for the increase in incidence and AP-associated mortality as there was no previous study done to focus on these areas.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Assessment of Knowledge and Early Management of Acute Pancreatitis Among Residents

Mehmood¹,

Ullah²,

Chan³

et al. 2019

Cureus

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“…[15] A previous study reported improvements concerning complications, duration of hospital stay, and morbidity and mortality rates of patients followed and treated according to the standard guidelines or protocols. [16] There are many obstacles, including the lack of knowledge of surgeons and the lack of clinical decision support tools, which may lead to non-compliance or poor compliance with standard guidelines. Despite all the barriers, training of major physicians and better definition of clinical decision support tools have resulted in tighter adherence to the guidelines and better clinical outcomes during the management of acute pancreatitis.…”

Section: Discussionmentioning

confidence: 99%

“…Despite all the barriers, training of major physicians and better definition of clinical decision support tools have resulted in tighter adherence to the guidelines and better clinical outcomes during the management of acute pancreatitis. [15,16] A similar survey study, which addressed the lack of knowledge of physicians, was conducted with internal medicine and surgical physicians at Abington Jefferson Health; however, the proportion of surgical physicians was relatively low. [17] We should note that similar results in our study indicated a lack of knowledge among the physicians.…”

Section: Discussionmentioning

confidence: 99%

Different Approaches In Diagnosis, Follow-Up And Treatment Of Acute Biliary Pancreatitis - Results Of Attitude Survey

Somuncu

Sarıcı

Kizilkaya

et al. 2020

Ulus Travma Acil Cerrahi Derg

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BACKGROUND:Acute biliary pancreatitis is one of the most frequently encountered diseases among general surgeons in emergency surgical diseases. Differences in diagnosis and treatment management of these patients, varying from physician to physician, are common in clinical practice. We aimed to present these differences and discuss the results in the light of current guidelines in the literature. METHODS:In this study, 21 questions were prepared regarding the physicians' approach in the diagnosis, follow-up and treatment of acute biliary pancreatitis (Appendix).The questionnaires were completed by face to face interviews with 94 general surgery specialists at the 20th National Surgery Congress. RESULTS:In this study, 38 (40%) of the physicians who answered the questionnaire were working in the Training and Research Hospital, 27 (29%) in the State Hospital, 19 (20%) in the University Hospital and nine in private health care was working in the establishment. 85% of the physicians were general surgery specialists with 10 years of experience. 53% (50) of the surgeons reported that they had less than five cases of acute biliary pancreatitis each month, and 35% (34) stated that they wanted amylase value daily for follow-up. Ultrasonography and computed tomography were the most commonly used imaging modalities and 15% of the respondents indicated that each patient underwent magnetic resonance cholangiopancreatography. 45% of surgeons stated that antibiotics were started at the time of diagnosis of pancreatitis. The percentage of surgeons who did not undergo cholecystectomy early in patients with mild to moderate pancreatitis was 60%. The reason for not preferring surgery in the early period was the most frequent operation difficulty with 40% and not supporting the operation in the early period. CONCLUSION:According to the attitude survey results, there are differences between general surgery specialists in the diagnosis, follow-up and treatment of acute biliary pancreatitis.Keywords: Acute biliary pancreatitis; an attitude survey of pancreatitis; management of pancreatitis.the American College of Gastroenterology (ACG) guidelines (revised in 2013) is the highest among the American-based guidelines. [2] In addition, there are three other approved international guidelines-British Gastroenterology Association guidelines, the Japan Association of Abdominal Emergency Medicine guidelines, and the International Association of Pancreatology (AP) guidelines. [3][4][5] Some institutions also have their own guidelines. [6]

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Effect of early hemofiltration on pro- and anti-inflammatory responses and multiple organ failure in severe acute pancreatitis

Yang

Wang

Jing

et al. 2004

Current Medical Science

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The effects of early hemofiltration on the serum levels of cytokines, pro- and anti-inflammatory balance and organ function in pigs with severe acute pancreatits (SAP) were studied. SAP pig model was induced by retrograde injection of artificial bile into the pancreatic duct. The pigs were randomly divided into SAP hemofiltration treatment group (HF group, n=8) and SAP non-hemofiltration treatment group (NHF group, n=8). In the HF group, the animals were subjected to high-volume and zero-balance hemofiltration therapy. The results showed that as compared with NHF group, MAP, CVP and PaO2/FiO2 were significantly increased (P<0.01), while HR, urinary protein content, serum ALT level, pulmonary coefficient and lung wet/dry ratio obviously decreased (P<0.05) in HF group. Under a light microscope, the pulmonary histologic scoring was lower that in HF group (P<0.01) and the lesions of renal and liver tissues were milder. However, there was no significant difference in the pancreatic histologic scoring between the two groups. Six h after establishment of the model, the serum levels of TNF-alpha, IL-1beta were lower, while the IL-10/ TNF-alpha ratio was higher in HF group (all P<0.05). It was suggested that early hemofiltration could effectively remove the serum cytokines TNF-alpha and IL-1beta in SAP pigs, elevate the ratio of IL-10/TNF-alpha, improve hemodynamics and alleviate the lesions of lung, kidney and liver tissues.

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Die Bedeutung eines klinischen Protokolls bei der Behandlung der schweren akuten Pankreatitis

Cited by 4 publications

References 39 publications

The Assessment of Knowledge and Early Management of Acute Pancreatitis Among Residents

The Assessment of Knowledge and Early Management of Acute Pancreatitis Among Residents

Different Approaches In Diagnosis, Follow-Up And Treatment Of Acute Biliary Pancreatitis - Results Of Attitude Survey

Effect of early hemofiltration on pro- and anti-inflammatory responses and multiple organ failure in severe acute pancreatitis

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