Management of severe acute pancreatitis: itʼs all about timing
العنوان: | Management of severe acute pancreatitis: itʼs all about timing |
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المؤلفون: | Hein G. Gooszen, Hjalmar C. van Santvoort, Marc G. Besselink, Ben J.M. Witteman |
المصدر: | Current Opinion in Critical Care. 13:200-206 |
بيانات النشر: | Ovid Technologies (Wolters Kluwer Health), 2007. |
سنة النشر: | 2007 |
مصطلحات موضوعية: | Endoscopic ultrasound, medicine.medical_specialty, Time Factors, Critical Care, medicine.medical_treatment, Nutritional Status, Computed tomography, Critical Care and Intensive Care Medicine, law.invention, Enteral Nutrition, Randomized controlled trial, law, Laparotomy, Humans, Minimally Invasive Surgical Procedures, Medicine, Antibiotic prophylaxis, medicine.diagnostic_test, business.industry, Probiotics, Antibiotic Prophylaxis, medicine.disease, Surgery, Parenteral nutrition, Pancreatitis, Acute Disease, Endoscopic retrograde cholangiography, Acute pancreatitis, business |
الوصف: | Purpose of review This study provides an update on the treatment of severe acute pancreatitis (SAP) with emphasis on nutrition, infection-prophylaxis, biliary pancreatitis, surgical intervention and new randomized controlled trials. Recent findings The most relevant new insights are: (i) early enteral nutrition in SAP is not only capable of reducing infectious complications but may also reduce mortality; (ii) there is increasing evidence that antibiotic-prophylaxis is not capable of preventing infectious complications in SAP; (iii) probiotic-prophylaxis is being considered as an alternative with promising experimental results; (iv) in biliary pancreatitis, early endoscopic retrograde cholangiography with sphincterotomy (within 48 h) is beneficial in case of ampullary obstruction, although it may be withheld in the event of negative endoscopic ultrasound; (v) surgical intervention for infected (peri-)pancreatic necrosis is increasingly being postponed; (vi) minimally invasive strategies are being considered as a full alternative for necrosectomy by laparotomy in infected (peri-)pancreatic necrosis; (vii) the Atlanta classification should no longer be used to describe computed tomography findings in acute pancreatitis; and (viii) only five randomized controlled trials of patients with acute pancreatitis are currently registered in the international trial registries. Summary Timing of intervention is becoming increasingly important in SAP management. |
تدمد: | 1070-5295 |
الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e09e4db75e3975b41989a4599ce64837Test https://doi.org/10.1097/mcc.0b013e328015b8afTest |
حقوق: | RESTRICTED |
رقم الانضمام: | edsair.doi.dedup.....e09e4db75e3975b41989a4599ce64837 |
قاعدة البيانات: | OpenAIRE |