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Prevention, detection, and management of infected necrosis in severe acute pancreatitis.
- Source :
-
Current gastroenterology reports [Curr Gastroenterol Rep] 2009 Apr; Vol. 11 (2), pp. 104-10. - Publication Year :
- 2009
-
Abstract
- 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.
- Subjects :
- Antibiotic Prophylaxis
Bacterial Infections prevention & control
Clinical Trials as Topic
Enteral Nutrition methods
Evidence-Based Medicine
Humans
Minimally Invasive Surgical Procedures methods
Practice Guidelines as Topic
Probiotics therapeutic use
Time Factors
Pancreatitis, Acute Necrotizing diagnosis
Pancreatitis, Acute Necrotizing microbiology
Pancreatitis, Acute Necrotizing prevention & control
Pancreatitis, Acute Necrotizing therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1534-312X
- Volume :
- 11
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Current gastroenterology reports
- Publication Type :
- Academic Journal
- Accession number :
- 19281697
- Full Text :
- https://doi.org/10.1007/s11894-009-0017-3