Review of Therapeutic Management in Necrotizing Pancreatitis and Case Presentation at a Secondary Care Level
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Abstract
Acute pancreatitis (AP) is an inflammatory disease of the pancreatic parenchyma, resulting from the premature activation of pancreatic zymogens, with local and systemic repercussions. It represents one of the main causes of hospital admission for gastrointestinal pathologies, with predominant etiologies such as biliary (32-49%) and alcohol consumption (20-31%). Management depends on the severity and complications present. Although open laparotomy was historically used, minimally invasive techniques have demonstrated superiority in terms of clinical outcomes. Surgical options include open, percutaneous, laparoscopic and endoscopic necrosectomy, the selection of which depends on factors such as the availability of resources, surgical skills and the clinical condition of the patient.
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References
I. Arvanitakis, M., Ockenga, J., Bezmarevic, M., Gianotti, L., Krznarić, Ž., Lobo, D. N., Löser, C., Madl, C., Meier, R., Phillips, M., Rasmussen, H. H., Van Hooft, J. E., & Bischoff, S. C. (2020). ESPEN guideline on clinical nutrition in acute and chronic pancreatitis. Clinical Nutrition (Edinburgh, Scotland), 39(3), 612–631.
https://doi.org/10.1016/j.clnu.2020.01.004
II. Clark, C. J., Ray, J. W., Pawa, S., Jahann, D., McCullough, M., Miller, P., Mowery, N., Miller, M., Xiao, T., Koutlas, N., & Pawa, R. (2024). A location-based anatomic classification system for acute pancreatic fluid collections: Roadmap for optimal intervention in the step-up era. Surgery Open Science, 18, 1–5.
https://doi.org/10.1016/j.sopen.2024.01.008
III. Ma, Y., Ong, F., Hew, S., Swan, M., Devonshire, D., & Croagh, D. (2024). Repetitive endoscopic drainage as initial intervention is safe and effective for early treatment of pancreatic necrotic collections. ANZ Journal of Surgery, 94(5), 881–887. https://doi.org/10.1111/ans.18852
IV. Maurer, L. R., & Fagenholz, P. J. (2023). Contemporary surgical management of pancreatic necrosis. JAMA Surgery, 158(1), 81–88. https://doi.org/10.1001/jamasurg.2022.5695
V. Niu, C. G., Zhang, J., Zhu, K. W., Liu, H. L., Ashraf, M. F., & Okolo, P. I., 3rd. (2023). Comparison of early and late intervention for necrotizing pancreatitis: A systematic review and meta-analysis. Journal of Digestive Diseases, 24(5), 321–331. https://doi.org/10.1111/1751-2980.13201
VI. Palumbo, R., & Schuster, K. M. (2024). Contemporary management of acute pancreatitis: What you need to know. The Journal of Trauma and Acute Care Surgery, 96(1), 156–165. https://doi.org/10.1097/TA.0000000000004143
VII. Rayman, S., Jacoby, H., Guenoun, K., Oliphant, U., Nelson, D., Kaiser, A., & Sucandy, I. (2023). Diagnosis and contemporary management of necrotizing pancreatitis. The American Surgeon, 89(11), 4817–4825.
https://doi.org/10.1177/00031348231156781
VIII. Sagar, A. J., Khan, M., & Tapuria, N. (2022). Evidence-based approach to the surgical management of acute pancreatitis. The Surgery Journal, 8(4), e322–e335. https://doi.org/10.1055/s-0042-1758229
IX. Samanta, J., Dhar, J., Muktesh, G., Gupta, P., Kumar-M, P., Das, A., Agarwala, R., Bellam, B. L., Chauhan, R., Kumar, K. H., Yadav, T. D., Gupta, V., Sinha, S. K., Kochhar, R., & Facciorusso, A. (2022). Endoscopic drainage versus percutaneous drainage for the management of infected walled-off necrosis: a comparative analysis. Expert Review of Gastroenterology & Hepatology, 16(3), 297–305. https://doi.org/10.1080/17474124.2022.2047649
X. Sato, T., Saito, T., Takenaka, M., Iwashita, T., Shiomi, H., Fujisawa, T., Hayashi, N., Iwata, K., Maruta, A., Mukai, T., Masuda, A., Matsubara, S., Hamada, T., Inoue, T., Ohyama, H., Kuwatani, M., Kamada, H., Hashimoto, S., Shiratori, T., … WONDERFUL study group in Japan, collaborators. (2023). WONDER-01: immediate necrosectomy vs. drainage-oriented step-up approach after endoscopic ultrasound-guided drainage of walled-off necrosis-study protocol for a multicentre randomised controlled trial. Trials, 24(1), 352. https://doi.org/10.1186/s13063-023-07377-y
XI. Sivakumar, S. G., Sekaran, M., Muthukrishnan, S., Natesan, A. V., Nalankilli, V. P., Senthilnathan, P., & Palanivelu, C. (2024). Laparoscopic necrosectomy for acute necrotising pancreatitis: Retrospective analysis of a decade-long experience from a tertiary centre. Journal of Minimal Access Surgery, 20(2), 127–135.
https://doi.org/10.4103/jmas.jmas_215_22
XII. Trikudanathan, G., Wolbrink, D. R. J., van Santvoort, H. C., Mallery, S., Freeman, M., & Besselink, M. G. (2019). Current concepts in severe acute and necrotizing pancreatitis: An evidence-based approach. Gastroenterology, 156(7), 1994-2007.e3. https://doi.org/10.1053/j.gastro.2019.01.269
XIII. Troncone, E., Amendola, R., Gadaleta, F., De Cristofaro, E., Neri, B., De Vico, P., Paoluzi, O. A., Monteleone, G., Anderloni, A., & Del Vecchio Blanco, G. (2024). Indications, techniques and future perspectives of walled-off necrosis management. Diagnostics (Basel, Switzerland), 14(4), 381.
https://doi.org/10.3390/diagnostics14040381
XIV. Van Wieren, A., Guild, M., Raucci, N., & Meyer, S. (2022). Managing severe acute and necrotizing pancreatitis. JAAPA : Official Journal of the American Academy of Physician Assistants, 35(6), 15–20. https://doi.org/10.1097/01.JAA.0000830176.03626.15
XV. Zhang, H.-Y., & He, C.-C. (2024). Early endoscopic management of an infected acute necrotic collection misdiagnosed as a pancreatic pseudocyst: A case report. World Journal of Gastrointestinal Surgery, 16(2), 609–615.
https://doi.org/10.4240/wjgs.v16.i2.609
XVI. Trikudanathan, G., Yazici, C., Evans Phillips, A., & Forsmark, C. E. (2024). Diagnosis and management of acute pancreatitis. Gastroenterology, 167(4), 673–688. https://doi.org/10.1053/j.gastro.2024.02.052