Acute pancreatitis surgery: Difference between revisions
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==Surgery== | ==Surgery== | ||
Surgery is indicated for | Surgery is indicated for | ||
# Infected | # Infected pancreatic necrosis | ||
# Diagnostic uncertainty and | # Diagnostic uncertainty and | ||
# Complications. | # Complications. |
Revision as of 18:13, 26 February 2013
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]
Surgery
Surgery is indicated for
- Infected pancreatic necrosis
- Diagnostic uncertainty and
- Complications.
The most common cause of death in acute pancreatitis is secondary infection. Infection is diagnosed based on 2 criteria
- Gas bubbles on CT scan (present in 20 to 50% of infected necrosis)
- Positive bacterial culture on FNA (fine needle aspiration, usually CT or US guided) of the pancreas.
Surgical options for infected necrosis include:
- Conventional management - necrosectomy with simple drainage
- Closed management - necrosectomy with closed continuous lavage
- Open management - necrosectomy with planned staged reoperations at definite intervals (up to 7 reoperations in some cases)