Necrotizing pancreatitis: challenges and solutions

Abstract

Acute pancreatitis is a common disease that can progress to gland necrosis, which imposes significant risk of morbidity and mortality. In general, the treatment for pancreatitis is a supportive therapy. However, there are several reasons to escalate to surgery or another intervention. This review discusses the pathophysiology as well as medical and interventional management of necrotizing pancreatitis. Current evidence suggests that patients are best served by delaying interventions for at least 4 weeks, draining as a first resort, and debriding recalcitrant tissue using minimally invasive techniques to promote or enhance postoperative recovery while reducing wound-related complications.

Gastroduodenal Artery Psuedoaneurysm Bleed through a Spontaneous Pancreaticoduodenal Fistula as a Result of Acute Necrotizing Pancreatitis

“…Acute pancreatitis, an inflammatory condition of the pancreas, is a major cause of hospital admission with an increasing incidence worldwide. 1 , 2 In the majority of cases, it has a mild, self-limiting course, but severe necrotizing pancreatitis is associated with significant morbidity and mortality. 3 Gallstones and alcohol use account for a majority of cases of acute pancreatitis.…”

Effect of negative pressure drainage with irrigation on peculiarities of microstructure of parapancraetic tissue and the dynamics of microflora in patients with infected necrotizing pancreatitis

“…2018;13(2):367-370. DOI -https://doi.org/10.14300/mnnc.2018.13051 являются активность инфекционного процесса и состояние ткани парапанкреатической клетчатки [2,3]. В литературе обсуждается проблема лечения панкреонекроза с точки зрения характера повреждения и механизма смерти панкреатоцитов [4], однако вопрос о морфологических особенностях некротической ткани в парапанкреатической клетчатке при различных способах дренирования гнойного очага остается открытым.…”

Air Medical Transportation for Severe Acute Pancreatitis Patients over an Extra Long Distance: Is It Safe Enough?

“…The majority of AP patients have a mild disease course and recover within several days; however, about 15%–20% of the patients will develop severe AP (SAP) [ 2 – 4 ]. Persistent organ failure poses the greatest threat and causes the majority of mortality cases in SAP patients [ 5 ]. In view of the low incidence and the complicated pathophysiological process of SAP, the Japanese guideline recommends that severe cases should be transferred immediately to a facility capable of providing treatment for SAP [ 6 ].…”