Abstract
Acute pancreatitis is a very common inflammatory condition of the pancreas, which can result in significant morbidity and mortality. In most patients it has a mild course, however a minority can evolve to organ failure and pancreatic necrosis with potential infection. The diagnosis is made with a combination of clinical presentation, laboratory findings and imaging studies. Treatment varies according to the severity of the condition and it ranges from symptomatic measures to surgical interventions and antibiotic treatment. Open necrosectomy is associated with high morbidity, therefore multidisciplinary methods, focused in drainage and a “step-up” approach, starting with minimally invasive techniques and progressing, if necessary, to invasive techniques is preferred.
Keywords
References
Moggia E, Koti R, Belgaumkar AP, Fazio F, Pereira SP, Davidson BR, Gurusamy KS. Pharmacological interventions for acute pancreatitis (Review). Cochrane Database of Systematic Reviews [internet] 2017 [consultado 26 oct 2019]; Issue 4. Disponible en: www.cochranelibrary.com
Zhou Q, Melton D.A. Pancreas regeneration. Nature [internet] 2018 [consultado 26 oct 2019]; Vol 557 (351-358). Disponible en: https://doi.org/10.1038/s41586-018-0088-0
Habtezion A. Inflammation in acute and chronic pancreatitis. Curr Opin Gastroenterol [internet] 2015 [consultado 26 oct 2019]; 31 (395-399). Disponible en: www.co-gastroenterology.com
Lodewijkx P, Besselink M.G, Witteman B.J, Schepers N.J, Gooszen H.G, van Santvoort H.C, Bakker O.J. Nutrition in acute pancreatitis: a critical review. Expert Review of Gastroenterology & Hepatology [internet] 2016 [consultado 26 oct 2019]; 1747-4132. Disponible en: http://dx.doi.org/10.1586/17474124.2016.1141048
Bollen T.L. Acute pancreatitis: international classification and nomenclature. Clinical Radiology [internet] 2015 [consultado 26 oct 2019]; 71(2) 121-133. Disponible en: http://dx.doi.org/10.1016/j.crad.2015.09.013
Johnson C.D, Besselink M.G, Carter R. Acute pancreatitis. BMJ [internet] 2014 [consultado 26 oct 2019]; 349 (g4859). Disponible en: https://doi.org/10.1136/bmj.g4859
Fung C, Svystun O, Fadaei Fouladi D, Kawamoto S. CT imaging, classification, and complications of acute pancreatitis. Abdom Radiol [internet] 2019 [consultado 26 oct 2019]; doi: 10.1007/s00261-019-02236-4. Disponible en: https://doi.org/10.1007/s00261-019-02236-4
Roberts S.E, Morrison-Rees S, John A, Williams J.G, Brown T, Samuel D.G. The incidence and aetiology of acute pancreatitis in Europe. Pancreatology [internet] 2017 [consultado 26 oct 2019]; 17(2) 155-165. Disponible en: https://doi.org/10.1016/j.pan.2017.01.005
Pagliari D, Rinninella E, Cianci R, Attili F, Franza L, Luciano R, Mancarella F.A, Rizzatti G, Musso M, Cintoni M, Gasbarrini A, Mele M.C. Early oral vs parenteral nutrition in acute pancreatitis: a retrospective analysis of clinical outcomes and hospital costs from a tertiary care referral center. Internal and Emergency Medicine [internet] 2019 [consultado 26 oct 2019]; Disponible en: https://doi.org/10.1007/s11739-019-02210-4
Mandalia A, Wamsteker E-J, DiMagno M.J. Recent advances in understanding and managing acute pancreatitis. F1000 Research [internet] 2019 [consultado 26 oct 2019]; 7 (959). Disponible en: https://doi.org/10.12688/f1000research.14244.2
Zhong F-P, Wang K, Tan X-Q, Nie J, Huang W-F, Wang X-F. The optimal timing of laparoscopic cholecystectomy in patients with mild gallstone pancreatitis. Medicine [internet] 2019 [consultado 26 oct 2019]; 98:40(e17429). Disponible en: http://dx.doi.org/10.1097/MD.0000000000017429
Johnstone C. Pathophysiology and nursing management of acute pancreatitis. Nursing Standard [internet] 2018 [consultado 26 oct 2019]; vol. 33 num. 4 (75-82). Disponible en: https://doi.org/10.7748/ns.2018.e11179
Paulino J, Ramos G, Veloso Gomes F. Together We Stand, Divided We Fall: A Multidisciplinary Approach in Complicated Acute Pancreatitis. J. Clin. Med [internet] 2019 [consultado 26 oct 2019]; 8 (1607). Disponible en: https://doi.org/10.3390/jcm8101607
Lankisch P.G, Apte M, Banks P.A. Acute Pancreatitis. Lancet [internet] 2015 [consultado 18 mar 2020]; vol 386 (85-96). Disponible en: https://doi.org/10.1016/S0140-6736(14)60649-8
Rawla P, Sunkara T, Thandra K.C, Gaduputi V. Hypertriglyceridemia-induced pancreatitis: uptadet review of current treatment and preventive strategies. Clin Journal of Gastroenterol [internet] 2018. [consultado 18 mar 2020]; 11(6) (441-448). Disponible en: https://doi.org/ 10.1007/s12328-018-0881-1
Garg R, Rustagi T. Management of Hypertrygliceridemia Induced Acute Pancreatitis. Biomed Res Int [internet] 2018. [consultado 18 mar 2020]; 1-12. Disponible en: https://doi.org/10.1155/2018/4721357
De Pretis N, Amodio A, Frulloni L. Hypertriglyceridemic pancreatitis: Epidemiology, pathophysiology and clinical management. UEG Journal [Internet] 2018 [consultado 26 oct 2019]; vol 6(5) 649-655. Disponible en: https://doi.org/10.1177/2050640618755002
Farkas N, Hanak L, Miko A, Bajor J, Sarlos P, Czimmer J, Vincze A, Godi S, Pecsi D, Varju P, Marta K, Hegyi P.J, Eross B, Szakacs Z, Takacs T, Czako L, Nemeth B, Illes D, Kui B, Darvasi E, Izbeki F, Halasz A, Dunas-Varga V, Gajdan L, Hamvas J, Papp M, Foldi I, Feher K.E, Varga M, Csefko K, Torok I, Hunor-Pal F, Mickevicius A, Ramirez-Maldonado E, Sallinen V, Novak J, Ince A.T, Galeev S, Bod B, Sumegi J, Pencik P, Szepes A, Szentesi A, Parniczky A, Hegyi P. A Multicenter, International Cohort Analysis of 1435 Cases to Support Clinical Trial Design in Acute Pancreatitis. Frontiers in Physiology [internet] 2019 [consultado 26 oct 2019]; vol. 10 art. 1092. Disponible en: https://doi.org/10.1016/j.pan.2020.03.018
Pezzilli R, Zerbi A, Campra D, Capurso G, Golfieri R, Arcidiacono P.G, Billi P, Butturini G, Calculli L, Cannizzaro R, Carrara S, Crippa S, De Gaudio R, De Rai P, Frulloni L, Mazza E, Mutignani M, Pagano N, Rabitti P, Balzano G. Consensus guidelines on severe acute pancreatitis. Digestive and Liver Disease [internet] 2015 [consultado 26 oct 2019]; 47 (532-543). Disponible en: https://doi.org/10.1016/j.dld.2015.03.022
Sharbirde K.G, Galgano S.J, Morgan D.E. Traumatic pancreatitis. Abdom Radiol [internet] 2019 [consultado 26 oct 2019]; Disponible en: https://doi.org/10.1007/s00261-019-02241-7