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Surgery for Acute Pancreatitis

Lookup NU author(s): Sanjay PandanaboyanaORCiD

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Abstract

© 2015, Association of Surgeons of India.Surgery for acute pancreatitis has undergone significant changes over the last 3 decades. A better understanding of the pathophysiology has contributed to this, but the greatest driver for change has been the rise of less invasive interventions in the fields of laparoscopy, endoscopy and radiology. Surgery has a very limited role in the diagnosis of acute pancreatitis. The most common indication for intervention in acute pancreatitis is for the treatment of complications and most notably the treatment of infected walled off necrosis. Here, the step-up approach has become established, with prior drainage (either endoscopic or percutaneous) followed by delay for maturing of the wall and then debridement by endoscopic or minimally invasive surgical methods. Open surgery is only indicated when this approach fails. Other indications for surgery in acute pancreatitis are for the treatment of acute compartment syndrome, non-occlusive intestinal ischaemia and necrosis, enterocutaneous fistulae, vascular complications and pseudocyst. Surgery also has a role in the prevention of recurrent acute pancreatitis by cholecystectomy. Despite the more restricted role, surgeons have an important contribution to make in the multidisciplinary care of patients with complicated acute pancreatitis.

Publication metadata

Author(s): Navadgi S, Pandanaboyana S, Windsor JA

Publication type: Article

Publication status: Published

Journal: Indian Journal of Surgery

Year: 2015

Volume: 77

Issue: 5

Pages: 446-452

Online publication date: 13/10/2015

Acceptance date: 30/09/2015

ISSN (print): 0972-2068

ISSN (electronic): 0973-9793

Publisher: Springer

URL: https://doi.org/10.1007/s12262-015-1357-x

DOI: 10.1007/s12262-015-1357-x

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