Intervention in necrotizing pancreatitis: an evidence-based review of surgical and percutaneous alternatives.
Interventional therapy in necrotizing pancreatitis is evolving. Efforts to modify or prevent pancreatic necrosis by intra-arterial infusion of antibiotics and antiproteases have been described. Moreover, traditional approaches to the surgical management of infected pancreatic necrosis are being challenged by a host of endoscopic and percutaneous techniques. While these approaches are potentially valuable additions to interventional therapy in necrotizing pancreatitis, few evidence-based studies are available to support their supplanting more traditional approaches at this time. Cooperative evidence-based multiinstitutional studies will be required to address the validity of these proposals.
Bradley
Edward L
EL
Department of Clinical Sciences, Florida State University College of Medicine, Tallahassee, FL, USA. ed.bradley@med.fsu.edu
Howard
Thomas J
TJ
van Sonnenberg
Eric
E
Fotoohi
Mehran
M
D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D019317:Evidence-Based Medicine; D007261:Infusions, Intra-Arterial; D019283:Pancreatitis, Acute Necrotizing / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D010447:Peptide Hydrolases / Q000008:administration & dosage
D000900:Anti-Bacterial Agents; D010447:Peptide Hydrolases