Prevention, detection, and management of infected necrosis in severe acute pancreatitis

被引：24

作者：

Bakker O.J. ^{[1
]}

van Santvoort H.C. ^{[1
]}

Besselink M.G.H. ^{[1
]}

Harst E. ^{[1
]}

Hofker H.S. ^{[1
]}

Gooszen H.G. ^{[1
]}

机构：

[1] Department of Surgery, University Medical Center Utrecht, 3508 GA Utrecht

来源：

Current Gastroenterology Reports | 2009年 / 11卷 / 2期

关键词：

Pancreatitis; Acute Pancreatitis; Enteral Nutrition; Severe Acute Pancreatitis; Pancreatic Necrosis;

D O I：

10.1007/s11894-009-0017-3

中图分类号：

学科分类号：

摘要：

The management of infected peripancreatic or pancreatic necrosis in patients with severe pancreatitis has changed considerably in recent years. This review discusses the recent literature on prevention, detection, and management of infected necrosis. Though antibiotics, probiotics, and enteral nutrition have been tried to prevent infected necrosis, only enteral nutrition has consistently proven to be effective. Antibiotics and probiotics have not shown a consistent beneficial effect on outcome. Enteral nutrition reduced infectious complications and mortality in severe pancreatitis, compared with parenteral nutrition. The detection of infection of pancreatic necrosis is important for clinical decision making. Fine-needle aspiration may be used to confirm suspected infection, but if its results will not change clinical decisions, it should be omitted, as it may even introduce infection. Minimally invasive surgical, radiologic, or endoscopic intervention is increasingly being applied. In the absence of level 1 evidence, local expertise dictates which type of intervention is applied. © Current Medicine Group, LLC 2009.

引用

页码：104 / 110

页数：6

共 54 条

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