Acute pancreatitis and organ failure: Pathophysiology, natural history, and management strategies

被引:113
作者
Raraty M.G.T. [1 ]
Connor S. [1 ]
Criddle D.N. [1 ]
Sutton R. [1 ]
Neoptolemos J.P. [1 ]
机构
[1] Department of Surgery, University of Liverpool, Royal Liverpool University Hospital, Liverool L69 3GA, UCD Building, Daulby Street
关键词
Pancreatitis; Acute Pancreatitis; Acinar Cell; Severe Acute Pancreatitis; Pancreatic Necrosis;
D O I
10.1007/s11894-004-0035-0
中图分类号
学科分类号
摘要
Acute pancreatitis is a common condition that carries a significant risk of morbidity and mortality. It is characterized by intra-acinar cell activation of digestive enzymes and a subsequent systemic inflammatory response governed by the release of proinflammatory cytokines. In 80% of patients the disease runs a self-limiting course, but in the rest, pancreatic necrosis and systemic organ failure carry a mortality rate of up to 40%. The key to management is early identification of the patients liable to have a severe attack and require treatment in a high-dependency or critical-care setting by a specialist team. In gallstone-induced pancreatitis, early removal of ductal calculi by endoscopic sphincterotomy is indicated. The use of prophylactic antibiotics to prevent the infection of pancreatic necrosis remains controversial, but once established, infected necrosis must be removed. Although a number of techniques to accomplish this end have been described, minimally invasive techniques are gaining in popularity. Copyright © 2004 by Current Science Inc.
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页码:99 / 103
页数:4
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