Necrosectomy View Full Text


Ontology type: schema:Chapter     


Chapter Info

DATE

2016

AUTHORS

Oliver Strobel , Markus W. Büchler , Carlos Fernández-del Castillo , Gregory G. Tsiotos , Michael G. Sarr , C. Ross Carter , Euan J. Dickson , Hjalmar C. van Santvoort , Karen D. Horvath

ABSTRACT

Severe acute pancreatitis remains a life-threatening disease. The first phase (about 7 days) is characterized by formation of pancreatic and peripancreatic necrosis and development of a systemic inflammatory response syndrome. This systemic response to the pancreatic inflammation and necrosis causes early organ failure, which necessitates intensive care therapy. In the second phase (after the first week), the leading cause of morbidity and mortality is superinfection of necrosis with development of septic multiple organ failure. In the past two decades, treatment has evolved considerably, and with improved aggressive initial resuscitation and intensive care management. There is a worldwide trend toward a more conservative strategy of delayed operative intervention. Treatment is initiated primarily because of the local and systemic manifestations of infected necrosis and less so for sterile necrosis. Nevertheless, septic complications caused by pancreatic infection account for 80 % of the mortality, so infected necrosis usually remains an absolute indication for some form of invasive intervention. The goals of operative necrosectomy are to remove the necrotic and infected tissue and to minimize injury to viable tissues. Each technique described below also aims to minimize the accumulation of exudative fluid and extravasated pancreatic exocrine secretions from the operative bed; if these are not drained, infection invariably occurs. More... »

PAGES

965-989

Book

TITLE

Atlas of Upper Gastrointestinal and Hepato-Pancreato-Biliary Surgery

ISBN

978-3-662-46545-5
978-3-662-46546-2

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/978-3-662-46546-2_99

DOI

http://dx.doi.org/10.1007/978-3-662-46546-2_99

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1024163955


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