TY - JOUR
T1 - Current Concepts in Severe Acute and Necrotizing Pancreatitis
T2 - An Evidence-Based Approach
AU - Trikudanathan, Guru
AU - Wolbrink, Daniel R.J.
AU - van Santvoort, Hjalmar C.
AU - Mallery, Shawn
AU - Freeman, Martin
AU - Besselink, Marc G.
N1 - Publisher Copyright:
© 2019 AGA Institute
PY - 2019/5
Y1 - 2019/5
N2 - The incidence of acute pancreatitis continues to rise, inducing substantial medical and social burden, with annual costs exceeding $2 billion in the United States alone. Although most patients develop mild pancreatitis, 20% develop severe and/or necrotizing pancreatitis, requiring advanced medical and interventional care. Morbidity resulting from local and systemic complications as well as invasive interventions result in mortality rates historically as high as 30%. There has been substantial evolution of strategies for interventions in recent years, from open surgery to minimally invasive surgical and endoscopic step-up approaches. In contrast to the advances in invasive procedures for complications, early management still lacks curative options and consists of adequate fluid resuscitation, analgesics, and monitoring. Many challenges remain, including comprehensive management of the entire spectrum of the disease, which requires close involvement of multiple disciplines at specialized centers.
AB - The incidence of acute pancreatitis continues to rise, inducing substantial medical and social burden, with annual costs exceeding $2 billion in the United States alone. Although most patients develop mild pancreatitis, 20% develop severe and/or necrotizing pancreatitis, requiring advanced medical and interventional care. Morbidity resulting from local and systemic complications as well as invasive interventions result in mortality rates historically as high as 30%. There has been substantial evolution of strategies for interventions in recent years, from open surgery to minimally invasive surgical and endoscopic step-up approaches. In contrast to the advances in invasive procedures for complications, early management still lacks curative options and consists of adequate fluid resuscitation, analgesics, and monitoring. Many challenges remain, including comprehensive management of the entire spectrum of the disease, which requires close involvement of multiple disciplines at specialized centers.
KW - Acute Pancreatitis
KW - Necrotizing Pancreatitis
KW - Severe Acute Pancreatitis
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U2 - 10.1053/j.gastro.2019.01.269
DO - 10.1053/j.gastro.2019.01.269
M3 - Article
C2 - 30776347
AN - SCOPUS:85064538011
SN - 0016-5085
VL - 156
SP - 1994-2007.e3
JO - Gastroenterology
JF - Gastroenterology
IS - 7
ER -