Necrotizing pancreatitis: new definitions and a new era in surgical management

Surgical Infections
Andrew RosenbergLena M Napolitano

Abstract

Necrotizing pancreatitis is a challenging condition that requires surgical treatment commonly and is associated with substantial morbidity and mortality. Over the past decade, new definitions have been developed for standardization of severity of acute and necrotizing pancreatitis, and new management techniques have emerged based on prospective, randomized clinical trials. Review of English-language literature. A new international classification of acute pancreatitis has been developed by PANCREA (Pancreatitis Across Nations Clinical Research and Education Alliance) to replace the Atlanta Classification. It is based on the actual local (whether pancreatic necrosis is present or not, whether it is sterile or infected) and systemic determinants (whether organ failure is present or not, whether it is transient or persistent) of severity. Early management requires goal-directed fluid resuscitation (with avoidance of over-resuscitation and abdominal compartment syndrome), assessment of severity of pancreatitis, diagnostic computed tomography (CT) imaging to assess for necrotizing pancreatitis, consideration of endoscopic retrograde cholangiopancreatography (ERCP) for biliary pancreatitis and early enteral nutrition support. Antibiot...Continue Reading

References

Sep 9, 1995·Lancet·V SainioE Kivilaakso
Jan 1, 1993·Annales de chirurgie·E L Bradley
Feb 1, 1997·American Journal of Surgery·J MierR Blanco
May 6, 1999·The New England Journal of Medicine·T H Baron, D E Morgan
Feb 13, 2001·The British Journal of Surgery·M L Kylänpää-BäckH Repo
Jan 17, 2002·The New England Journal of Medicine·E RiversUNKNOWN Early Goal-Directed Therapy Collaborative Group
May 23, 2002·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Werner HartwigErnst Klar
Jun 26, 2002·Journal of the American College of Surgeons·Eric S HungnessFred A Luchette
Jul 4, 2002·The American Journal of Gastroenterology·Dhiraj YadavC S Pitchumoni
Dec 24, 2002·Journal of the American College of Surgeons·Thomas J Howard, Michael B Temple
Jul 12, 2003·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Jan J De WaeleF Colardyn
Apr 2, 2004·Gastroenterology·Rainer IsenmannUNKNOWN German Antibiotics in Severe Acute Pancreatitis Study Group
Jun 17, 2004·JAMA : the Journal of the American Medical Association·Vege Santhi SwaroopJonathan E Clain
Dec 22, 2004·Archives of Surgery·Jan J De WaeleFrancis Colardyn
Jan 26, 2005·The American Journal of Gastroenterology·F C EatockC W Imrie
Jun 10, 2005·ANZ Journal of Surgery·Ross C SmithDouglas Chesher
Jan 25, 2006·Annals of Surgery·Stefan HeinrichPierre-Alain Clavien
Feb 8, 2006·Journal of Hepato-biliary-pancreatic Surgery·Shuji IsajiUNKNOWN JPN
Feb 28, 2006·Journal of the American College of Surgeons·Edgar A Guzman, Marek Rudnicki
Mar 7, 2006·JPEN. Journal of Parenteral and Enteral Nutrition·Stephen A McClaveDaren K Heyland
May 19, 2006·The New England Journal of Medicine·David C Whitcomb
May 9, 2007·Gastroenterology·Chris E ForsmarkUNKNOWN AGA Institute Governing Board
Nov 7, 2007·The British Journal of Surgery·T L BollenUNKNOWN Dutch Acute Pancreatitis Study Group
Dec 19, 2007·Archives of Surgery·Marc G H BesselinkHein G Gooszen
Dec 20, 2007·Pancreas·Peter J FagenholzCarlos A Camargo
Dec 17, 2008·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·A García-BarrasaJ Fabregat
Apr 7, 2009·Gastroenterology·Bechien U WuPeter A Banks
Aug 22, 2009·Chest·Anand KumarUNKNOWN Cooperative Antimicrobial Therapy of Septic Shock Database Research Group
Oct 29, 2009·The American Journal of Gastroenterology·Georgios I PapachristouDavid C Whitcomb
Apr 23, 2010·The New England Journal of Medicine·Hjalmar C van SantvoortUNKNOWN Dutch Pancreatitis Study Group
Apr 23, 2010·The New England Journal of Medicine·Andrew L Warshaw
Jun 12, 2010·F1000 Medicine Reports·Matthew J DimagnoAnthony T Debenedet
Apr 6, 2011·Journal of the American College of Surgeons·Danny SleemanAlan S Livingstone

❮ Previous
Next ❯

Citations

May 3, 2016·Emergency Medicine Clinics of North America·Patrick Robinson, John C Perkins
Feb 3, 2018·Surgical Infections·John C Alverdy
Sep 4, 2020·American Journal of Surgery·Shravan Leonard-MuraliArielle H Gupta

❮ Previous
Next ❯

Methods Mentioned

BETA
lavage
pancreatectomy

Clinical Trials Mentioned

ISRCTN13975868
NCT00793715

Software Mentioned

PANTER
DECOMPRESS
TENSION
PancMap
PANCREA

Related Concepts

Related Feeds

Antifungals

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.

Antifungals (ASM)

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.

Related Papers

Expert Review of Gastroenterology & Hepatology
Guru TrikudanathanMartin L Freeman
Current Treatment Options in Gastroenterology
Rahul Pannala, Andrew S Ross
Current Treatment Options in Gastroenterology
Diana A Whitehead, Timothy B Gardner
World Journal of Clinical Cases
José Manuel Aranda-NarváezJulio Santoyo-Santoyo
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Radhika LakshmananKrishnakumar Madhavan
© 2021 Meta ULC. All rights reserved