摘要 :
A great deal of progress has been made in the last 50 years in the diagnosis and treatment of acute pancreatitis. Many landmark studies have been published and have focused on the classification of acute pancreatitis, markers of s...
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A great deal of progress has been made in the last 50 years in the diagnosis and treatment of acute pancreatitis. Many landmark studies have been published and have focused on the classification of acute pancreatitis, markers of severity, important roles of imaging and endoscopy, and improvements in our treatment. This report will review several landmark studies, describe ongoing controversies in management decisions including standards of early fluid resuscitation and appropriate use of enteral feeding, and outline what will be required in the future to improve the care of patients with acute pancreatitis.
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摘要 :
Acute pancreatitis is a protean disease capable of wide clinical variation, ranging from mild discomfort to severe organ failure. Moreover, the inflammatory process may remain localized in the pancreas, spread to regional tissues,...
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Acute pancreatitis is a protean disease capable of wide clinical variation, ranging from mild discomfort to severe organ failure. Moreover, the inflammatory process may remain localized in the pancreas, spread to regional tissues, or even involve remote organ systems. This variability in presentation and clinical course has plagued the study and management of acute pancreatitis since its original clinical description. However, precise comprehension about the pathological physiology is required for better treatment. We described about the clinical classification and pathological physiology in the general in this
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This study aims to update the 1991 Atlanta Classification of acute pancreatitis, to standardize the reporting of and terminology of the disease and its complications. Important features of this classification have incorporated new...
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This study aims to update the 1991 Atlanta Classification of acute pancreatitis, to standardize the reporting of and terminology of the disease and its complications. Important features of this classification have incorporated new insights into the disease learned over the last 20 years, including the recognition that acute pancreatitis and its complications involve a dynamic process involving two phases, early and late. The accurate and consistent description of acute pancreatitis will help to improve the stratification and reporting of new methods of care of acute pancreatitis across different practices, geographic areas, and countries.
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Pancreatitis is divided into acute and chronic types. In recent years several classification schemes have been proposed which focus on the clinical, imaging, or morphological features of the disease. Because etiology has also beco...
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Pancreatitis is divided into acute and chronic types. In recent years several classification schemes have been proposed which focus on the clinical, imaging, or morphological features of the disease. Because etiology has also become an important criterion for the characterization of pancreatitis, a classification proposal is presented that attempts to include all relevant features of the disease: clinical presentation, outcome, pathology, and etiology.
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Objectives Acute pancreatitis (AP) is severe in up to 20% of patients, with a high mortality rate. Quantification of serum TH1 and TH2 cytokines may provide objective evidence to assess the severity of AP and predict its course.
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Background: The revised Atlanta classification on acute pancreatitis (AP) presents distinct criteria for severity categorization. Due to the lack of reliable prognostic markers, a majority of patients with AP are currently hospita...
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Background: The revised Atlanta classification on acute pancreatitis (AP) presents distinct criteria for severity categorization. Due to the lack of reliable prognostic markers, a majority of patients with AP are currently hospitalized and initially managed identically. As incidence and financial costs are rising the need for early severity differentiation will increase. This study aimed to investigate the capacity of biomarkers to stratify AP patients during the initial course of the disease.
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Background: Acute pancreatitis (AP) is an inflammatory disorder of the pancreas that can lead to local and systemic complications. Repeated attacks of AP can lead to chronic pancreatitis, which markedly increases the probability o...
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Background: Acute pancreatitis (AP) is an inflammatory disorder of the pancreas that can lead to local and systemic complications. Repeated attacks of AP can lead to chronic pancreatitis, which markedly increases the probability of developing pancreatic cancer. Although many researchers have attempted to identify the pathogenesis involved in the initiation and aggravation of AP, the disease is still not fully understood, and effective treatment is limited to supportive therapy.
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Acute pancreatitis is an acute inflammatory process of the pancreatic gland with increasing incidence worldwide. Usually the clinical presentation and course are mild, with an uneventful recovery. In 10% to 20% of patients, howeve...
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Acute pancreatitis is an acute inflammatory process of the pancreatic gland with increasing incidence worldwide. Usually the clinical presentation and course are mild, with an uneventful recovery. In 10% to 20% of patients, however, local and systemic complications develop, resulting in significant morbidity and mortality. In 1992, the Atlanta symposium provided definitions for acute pancreatitis and its severity. Insights into the pathophysiology of the disease, improved diagnostic imaging, and implementation of minimally invasive techniques have led to classification updates. This article reviews the cross-sectional imaging features of acute pancreatitis and presents proposed definitions of the revised Atlanta classification.
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Purpose: The purpose of this study is to compare short-term and midterm outcomes between patients with acute pancreatitis (AP) treated with minimally invasive surgery (MIS) and patients treated with open necrosectomy (ON). Materia...
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Purpose: The purpose of this study is to compare short-term and midterm outcomes between patients with acute pancreatitis (AP) treated with minimally invasive surgery (MIS) and patients treated with open necrosectomy (ON). Materials and Methods: We compared data of all patients who had undergone MIS for AP with a similar group of patients with ON patients between January 2012 and June 2021 using a case-matched methodology based on AP severity and patient characteristics. Inhospital and midterm follow-up variables, including quality-oflife assessment, were evaluated. Results: Starting from a whole series of 79 patients with moderate to critical AP admitted to our referral center, the final study sample consisted of 24 patients (12 MIS and 12 ON). Post-operative (18.7 +/- 10.9 vs. 30.3 +/- 21.7 d; P = 0.05) and overall hospitalization (56.3 +/- 17.4 vs. 76.9 +/- 39.4 d; P = 0.05) were lower in the MIS group. Moreover, the Short-Form 36 scores in the ON group were statistically significantly lower in role limitations because of emotional problems (P = 0.002) and health changes (P = 0.03) at 3 and 6 months and because of emotional problems (P = 0.05), emotional well-being (P = 0.02), and general health (P = 0.007) at 1 year. Conclusions: MIS for the surgical management of moderate to critical AP seems to be a good option, as it could provide more chances for a better midterm quality of life compared with ON. Further studies are needed to confirm our findings.
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