The management of suspected pancreatic sepsis.
The management of infected pancreatic necrosis is centered on image-guided fine needle aspiration followed by antibiotic therapy that is based on microbiologic culture results. The authors favor targeted antibiotic therapy rather than routine prophylactic antibiotic coverage. Prompt surgical debridement is recommended for patients who have infected necrosis who are suitable operative candidates. Newer surgical, percutaneous, and endoscopic techniques, as well as prolonged antibiotic therapy without intervention, are being evaluated as alternatives to operative debridement. Well-designed prospective trials will help to determine optimal treatment for patients who have infected pancreatic necrosis.
Berzin
Tyler M
TM
Department of Medicine, Division of Gastroenterology, Department of Radiology, and Center for Pancreatic Disease, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
Mortele
Koenraad J
KJ
Banks
Peter A
PA
D006801:Humans; D010182:Pancreatic Diseases / Q000175:diagnosis / Q000628:therapy*; D010195:Pancreatitis / Q000628:therapy