title: Surgical decompression for abdominal compartment syndrome in severe acute pancreatitis.
abstract: OBJECTIVE
  In patients with severe acute pancreatitis and abdominal compartment syndrome, establishment of the indications and optimal time for surgical decompression may avoid exacerbation of multiple-organ dysfunction syndrome.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Tertiary care university teaching hospital.
  
  
  METHODS
  Twenty-six consecutive patients with severe acute pancreatitis and abdominal compartment syndrome treated by surgical decompression between January 1, 2002, and December 31, 2007.
  
  
  METHODS
  Surgical decompression of the abdomen.
  
  
  METHODS
  Morbidity, mortality, and organ dysfunction before and after surgical decompression.
  
  
  RESULTS
  At the time of surgical decompression, the median sequential organ failure assessment score among patients was 12 (interquartile range, 10-15), and the median intra-abdominal pressure was 31.5 (interquartile range, 27-35) mm Hg. After surgical decompression, renal or respiratory function was improved in 14 patients (54%). The overall hospital mortality was 46%, but mortality was 18% among 17 patients in whom surgical decompression was performed within the first 4 days after disease onset.
  
  
  CONCLUSIONS
  Patients with severe acute pancreatitis and abdominal compartment syndrome managed by surgical decompression had severe multiple-organ dysfunction syndrome and high mortality. Surgical decompression may improve renal or respiratory function. Early surgical decompression is associated with reduced mortality in patients with severe acute pancreatitis, early multiple-organ dysfunction syndrome, and abdominal compartment syndrome.
authors: Department of Gastroenterologic and General Surgery, Helsinki University Central Hospital, PO Box 340, 00029 HUS, Helsinki, Finland. panu.mentula@hus.fi
authors: Panu
authors: P
authors: Mentula
authors: Piia
authors: P
authors: Hienonen
authors: Esko
authors: E
authors: Kemppainen
authors: Pauli
authors: P
authors: Puolakkainen
authors: Ari
authors: A
authors: Leppäniemi
mesh_terms: D000005:Abdomen; D000328:Adult; D003161:Compartment Syndromes / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D019299:Decompression, Surgical; D018450:Disease Progression; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000517:prevention & control; D010195:Pancreatitis / Q000150:complications* / Q000401:mortality; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors