Acute pancreatitis surgery: Difference between revisions
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{{Acute pancreatitis}} | {{Acute pancreatitis}} | ||
{{CMG}}; {{AE}} {{RT}} | {{CMG}}; {{AE}} {{RT}} | ||
==Overview== | |||
[[Surgery]] in the treatment of acute pancreatitis is indicated for infected pancreatic necrosis, in cases of diagnostic uncertainty and in the presence of complications. | |||
==Surgery== | ==Surgery== | ||
Surgery is indicated for | Surgery is indicated for | ||
# Infected pancreatic necrosis | # Infected pancreatic necrosis | ||
# Diagnostic uncertainty | # Diagnostic uncertainty | ||
# Complications. | # Complications. | ||
The most common cause of death in acute pancreatitis is secondary [[infection]]. Infection is diagnosed based on 2 criteria | 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) | *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]]. | *Positive bacterial culture on FNA ([[fine needle aspiration]], usually CT or US guided) of the [[pancreas]]. | ||
Revision as of 18:20, 26 February 2013
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Acute pancreatitis Microchapters |
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Acute pancreatitis surgery On the Web |
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American Roentgen Ray Society Images of Acute pancreatitis surgery |
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Risk calculators and risk factors for Acute pancreatitis surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]
Overview
Surgery in the treatment of acute pancreatitis is indicated for infected pancreatic necrosis, in cases of diagnostic uncertainty and in the presence of complications.
Surgery
Surgery is indicated for
- Infected pancreatic necrosis
- Diagnostic uncertainty
- 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)