Update on the management of acute severe pancreatitis.

Abstract:

:Acute severe pancreatitis is an aggressive disease with a mortality rate of up to 30 percent. In recent years therapy has shifted away from early surgery to intensive medical care. This article focuses on several issues of the management of acute severe pancreatitis emphasising evidence from recent clinical trials and recommendations from recent consensus conferences. Since a correct assessment of the severity of the disease is mandatory as early as possible in the treatment, several multiple scoring factor systems and individual risk factors are explained. The indications and the optimal timing of ERCP are discussed. Prophylactic administration of antibiotics, intravenously or by means of a selective digestive decontamination scheme, seems to be beneficial in decreasing morbidity but not mortality. Adequate nutritional support, preferably achieved by enteral feeding, is an important component in the supportive therapy. Protease inhibitors and anti-secretory drugs have not proven to be of benefit in improving outcome. Immunomodulating substances like platelet activating antagonists are promising but further studies are necessary to confirm the results of the early studies. Finally, indications for surgery are discussed.

journal_name

Acta Clin Belg

journal_title

Acta clinica Belgica

authors

Ponette J,Wilmer A

doi

10.1179/acb.2001.023

keywords:

subject

Has Abstract

pub_date

2001-05-01 00:00:00

pages

135-45

issue

3

eissn

1784-3286

issn

2295-3337

journal_volume

56

pub_type

社论,评审
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