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Necrotizing pancreatitis: challenges and solutions

Authors Bendersky VA, Mallipeddi MK, Perez A, Pappas TN

Received 31 May 2016

Accepted for publication 2 September 2016

Published 31 October 2016 Volume 2016:9 Pages 345—350

DOI https://doi.org/10.2147/CEG.S99824

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Lucy Goodman

Peer reviewer comments 3

Editor who approved publication: Professor Andreas M Kaiser

Victoria A Bendersky,1 Mohan K Mallipeddi,2 Alexander Perez,2 Theodore N Pappas,2

1School of Medicine, 2Department of Surgery, Duke University, Durham, NC, USA

Abstract: Acute pancreatitis is a common disease that can progress to gland necrosis, which imposes significant risk of morbidity and mortality. In general, the treatment for pancreatitis is a supportive therapy. However, there are several reasons to escalate to surgery or another intervention. This review discusses the pathophysiology as well as medical and interventional management of necrotizing pancreatitis. Current evidence suggests that patients are best served by delaying interventions for at least 4 weeks, draining as a first resort, and debriding recalcitrant tissue using minimally invasive techniques to promote or enhance postoperative recovery while reducing wound-related complications.

Keywords: necrotizing pancreatitis, pancreatic necrosectomy, VARD, pancreatic debridement, pancreatic collections

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