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| Multidisciplinary management of patients with post-inflammatory pancreatic necrosis |
| Santhalingam Jegatheeswaran a , Joe Geraghty a , b , c , Ajith K Siriwardena a , c , ∗ |
a Regional Hepato-Pancreato-Biliary Surgery Unit, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK
b Department of Gastroenterology, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK
c Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK
∗ Corresponding author at: Regional Hepato-Pancreato-Biliary Surgery Unit, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK.
E-mail address: ajith.siriwardena@mft.nhs.uk (A.K. Siriwardena). |
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Abstract Current knowledge of the pathophysiology of acute pancreatitis indicates that pancreatic injury originates at the acinar cell level and then extends through a spectrum of damage ranging from mild peri-acinar inflammatory infiltration and edema to extensive pancreatic parenchymal and peri-pancreatic necrosis [1,2]. Clinical acute pancreatitis correlates closely with this range of injury with the majority of patients experiencing mild disease, some having transient organ dysfunction which typically recovers after adequate resuscitation (moderate acute pancreatitis) and a variable minority exhibiting sustained organ failure together with radiological evidence of pancreatic necrosis (severe acute pancreatitis) [2,3]. Worldwide, the management of this latter category of patients with severe acute pancreatitis remains a challenge. There is no effective direct medical treatment and there is no role for early pancreatic debridement [3,4]. This article provides a concise summary of current multidisciplinary management of patients with post-inflammatory pancreatic necrosis.
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2021, Vol. 20 
