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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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