Timing of catheter drainage in infected necrotizing pancreatitis View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2016-05

AUTHORS

Janneke van Grinsven, Hjalmar C. van Santvoort, Marja A. Boermeester, Cornelis H. Dejong, Casper H. van Eijck, Paul Fockens, Marc G. Besselink, Dutch Pancreatitis Study Group

ABSTRACT

Acute pancreatitis is the most common gastrointestinal indication for hospital admission, and infected pancreatic and/or extrapancreatic necrosis is a potentially lethal complication. Current standard treatment of infected necrosis is a step-up approach, consisting of catheter drainage followed, if necessary, by minimally invasive necrosectomy. International guidelines recommend postponing catheter drainage until the stage of 'walled-off necrosis' has been reached, a process that typically takes 4 weeks after onset of acute pancreatitis. This recommendation stems from the era of primary surgical necrosectomy. However, postponement of catheter drainage might not be necessary, and earlier detection and subsequent earlier drainage of infected necrosis could improve outcome. Strong data and consensus among international expert pancreatologists are lacking. Future clinical, preferably randomized, studies should focus on timing of catheter drainage in patients with infected necrotizing pancreatitis. In this Perspectives, we discuss challenges in the invasive treatment of patients with infected necrotizing pancreatitis, focusing on timing of catheter drainage. More... »

PAGES

306

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1038/nrgastro.2016.23

DOI

http://dx.doi.org/10.1038/nrgastro.2016.23

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1039510173

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/26956064


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