Management and outcomes of acute pancreatitis patients over the last decade: A US tertiary-center experience

Koutroumpakis, Efstratios; Slivka, Adam; Furlan, Alessandro; Dasyam, Anil K.; Dudekula, Anwar; Greer, Julia B.; Whitcomb, David C.; Yadav, Dhiraj; Papachristou, Georgios I.

doi:10.1016/j.pan.2016.10.011

Cited by 78 publications

(60 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[3][4][5] The overall case fatality rate for AP is roughly 5%, and is expectedly higher for more severe disease. 6 Patients with AP frequently experience abdominal pain, nausea, and vomiting, and the condition negatively impacts quality of life. 7 The most common causes of AP remain gallstones and alcohol, which together comprise 80% of cases; the remainder of cases are due to less common causes, including drug reactions, pancreatic solid and cystic malignancies, and hypertriglyceridemia.…”

mentioning

confidence: 99%

American Gastroenterological Association Institute Guideline on Initial Management of Acute Pancreatitis

et al. 2018

View full text Add to dashboard Cite

mentioning

confidence: 99%

American Gastroenterological Association Institute Guideline on Initial Management of Acute Pancreatitis

et al. 2018

View full text Add to dashboard Cite

“…Mean age of patients in our study was around 48 years which is comparable to other study carried out by Efstratios Koutroumpakis et al where mean age was 52 years. 14 The age, sex, clinical severity of acute pancreatitis was similar in two groups. The overall incidence of infections in AG and NAG was similar to the study done by Howes et al 12 However, the extra pancreatic infections observed in a study done by Rainer Isenmann et al was as high as 29% and 34% in AG vs.…”

Section: Discussionmentioning

confidence: 80%

Efficacy of Prophylactic use of Ciprofloxacin and Metronidazole in Mild and Moderately Severe Acute Pancreatitis

et al. 2017

View full text Add to dashboard Cite

Introduction:There are new concepts and developments in the diagnosis and management of acute pancreatitis. Current evidence suggests that there is no role of prophylactic antibiotics use in acute pancreatitis. However, it is still a common practice to administer prophylactic antibiotics in a country like Nepal. So, we have conducted a study in mild and moderately severe acute pancreatitis to study the efficacy of prophylactic antibiotics.Methods: A case control study was conducted among 76 patients comparing efficacy of prophylactic antibiotics versus no antibiotics in patients with mild and moderately severe acute pancreatitis. Results:The two most common etiology of acute pancreatitis in AG and NAG were alcohol 21 (55.2%) vs. 24 (63.1%) and biliary 10 (26.3%) vs. 4 (10.5%) respectively. Pancreatic necrosis was seen in five (13.1 %) in AG and four (10.5%) in NAG. Four (10.5%) developed extra pancreatic complications in AG and five (13.1%) in NAG. There was one (2.6%) death in AG and no death in NAG. Abdominal pain improvement seen in AG vs. NAG was 3.2 days vs. 2.4 days (P=0.002). The hospital stay was 7.7±2.23 days in AG and 7.5±1.85 days in NAG (P=0.65). Conclusions:The routine use of prophylactic antibiotics for mild and moderately severe acute pancreatitis is not associated with improvement in meaningful clinical outcomes.

show abstract

“…Bacteraemia has been shown to precede and increase the risk of developing infected (peri-) pancreatic necrosis (16) and therefore should be a strong consideration of the presence of infected (peri-)pancreatic necrosis. However, extrapancreatic sepsis such as pneumonia, venous catheters sepsis and urinary tract infections occur in up to 33% of patients with SAP (46) and therefore isolated bacteraemia should alert treating physicians to this possibility. Cross sectional imaging such as CT or MRI occasionally reveals gas within the (peri-)pancreatic necrosis ( Fig.…”

Section: Diagnosis Of Infectionmentioning

confidence: 99%

Managing Infected Pancreatic Necrosis

Thomson¹,

Dijk²,

Brand³

et al. 2018

chr

View full text Add to dashboard Cite

The management of infected pancreatic necrosis has historically been based on early, open necrosectomy, associated with significant mortality. In recent years, an evidence based transformation has occurred towards the step-up approach consisting of percutaneous catheter drainage, if necessary, followed by minimally invasive necrosectomy. More recently the endoscopic step-up approach has gained popularity. This review evaluates the diagnosis, prevention and treatment of infected necrotizing pancreatitis. Key points in managing infected pancreatic necrosis: - multidisciplinary team approach in tertiary level centres; - no indication for prophylactic antibiotics or probiotics; - nasogastric, enteral nutrition indicated after 72 hours, if oral feeding is insufficient; - only intervene in infected necrosis; - delay intervention until "walled-off necrosis"; - step-up approach of percutaneous or endoscopic catheter drainage, followed by minimally invasive necrosectomy, if required; - endoscopic strategies are preferable where possible.

show abstract

Management and outcomes of acute pancreatitis patients over the last decade: A US tertiary-center experience

Cited by 78 publications

References 28 publications

American Gastroenterological Association Institute Guideline on Initial Management of Acute Pancreatitis

American Gastroenterological Association Institute Guideline on Initial Management of Acute Pancreatitis

Efficacy of Prophylactic use of Ciprofloxacin and Metronidazole in Mild and Moderately Severe Acute Pancreatitis

Managing Infected Pancreatic Necrosis

Contact Info

Product

Resources

About