Current management of pancreatic abscess.
Without surgical debridement in patients with infected pancreatic necrosis, survival can not be expected. Previous surgical series reported postoperative survival in the range of 50%; however, more recent reports demonstrate improved mortality of 10% to 20%. Despite the demonstrated advances in surgical management, much remains to be done. Ongoing sepsis and the multiorgan failure syndrome (including ARDS, renal, and hepatic failure) are frequently part of the terminal phase of necrotizing pancreatitis, and further declines in mortality await future improvements in supportive therapy for overwhelming sepsis. Finding a means to prevent secondary infection of necrotizing pancreatitis would also have a very significant impact on survival. Defining the various form of severe acute pancreatitis and its infectious complications by dynamic pancreatography and CT-directed aspiration will permit meaningful trials of new methods to treat these unfortunate patients.
Bradley
E L
EL
Department of Surgery, Emory University School of Medicine, Atlanta, Georgia.
Olson
R A
RA
D000038:Abscess / Q000209:etiology / Q000628:therapy*; D000208:Acute Disease; D003131:Combined Modality Therapy; D003952:Diagnostic Imaging; D006801:Humans; D010182:Pancreatic Diseases / Q000209:etiology / Q000628:therapy*; D010195:Pancreatitis / Q000150:complications*