Please use this identifier to cite or link to this item: http://docs.prosentient.com.au/prosentientjspui/handle/1/10358
Title: Early surgical intervention in severe acute pancreatitis: Central Australian experience.
Authors: Jacob, Abraham O
Stewart, Penny
Jacob, Ollapallil
Affiliation: Department of Surgery, Alice Springs Hospital, Alice Springs, Northern Territory, Australia. aojacob@gmail.com..
Department of Surgery, Alice Springs Hospital, Alice Springs, Northern Territory, Australia..
Department of Surgery, Alice Springs Hospital, Alice Springs, Northern Territory, Australia..
Issue Date: Oct-2016
Citation: ANZ journal of surgery 2016-10; 86(10): 805-810
Abstract: Severe acute pancreatitis (SAP) is a disease associated with a high mortality and morbidity; however, many patients survive due to better understanding of the disease and multidisciplinary care. Those who do not respond to intensive care management with persistent multi-organ dysfunction still have a high mortality. There is a role for early surgical intervention in two subsets of critically ill patients: the first, with acute compartment syndrome (ACS) of the abdomen with persisting organ dysfunction despite medical measures to control intra-abdominal pressure; the second, being early infected pancreatic necrosis (IPN) with the presence of gas in the retroperitoneum. The current analysis is an 8-year (2005-2012) study. The data were collected prospectively by the Surgical Department in Alice Springs Hospital. Intensive care data were also sourced from ANZICS CORE (Australia and New Zealand Intensive Care Society and Centre for Outcome and Resource Evaluation) for ICU (intensive care unit) mortality comparison between ICUs of Australia and New Zealand with Alice Springs. There were 1163 episodes of acute pancreatitis with an annual incidence of 275 per 100 000. Of importance, 114 patients had SAP of whom 42 developed pancreatic necrosis. Eleven patients required surgical intervention. Five patients had decompressive laparotomies for ACS and six patients had laparotomies for IPN. The mortality of patients with SAP was 0%. The two subsets of patients with either ACS or early IPN require early surgical intervention either by decompressive laparotomy or open necrosectomy with laparostomy. The authors attribute improved survival in this cohort due to these interventions.
URI: http://docs.prosentient.com.au/prosentientjspui/handle/1/10358
DOI: 10.1111/ans.12707
Type: Journal Article
Subjects: abdominal compartment syndrome
infected pancreatic necrosis
laparostomy
necrosectomy
severe acute pancreatitis
Acute Disease
Adult
Aged
Female
Follow-Up Studies
Humans
Incidence
Intra-Abdominal Hypertension
Laparotomy
Male
Middle Aged
Northern Territory
Pancreas
Pancreatitis
Pancreatitis, Acute Necrotizing
Retrospective Studies
Severity of Illness Index
Treatment Outcome
Decompression, Surgical
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