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Az akut pancreatitis kezelésének aktuális kérdései a sebész szemszögéből. (Hungarian)
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- Author(s): Szentkereszty, Zsolt; Balog, Klaudia; Sass, Tamás; Tóth, Dezső
- Source:
Hungarian Medical Journal / Orvosi Hetilap; 2024, Vol. 165 Issue 15, p563-567, 5p - Source:
- Additional Information
- Alternate Title: Current issues related to treatment of acute pancreatitis from the surgeon's point of view. (English)
- Abstract: In recent times, the surgical treatment of acute pancreatitis has significantly changed. Indication and the surgical techniques for emergency operations are basically similar to the previous practice but new indication area has appeared. Abdominal compartment syndrome is an immediate indication for surgery if conservative and semi-conservative therapy is failed or ineffective. In these cases, decompressive laparotomy and open abdomen treatment combined with vacuum therapy are currently recommended. Instead of conventional pancreatic necrosectomy, minimal invasive procedures became more often used. Operations are suggested to be performed in the late stages of the disease when the so-called walled-off pancreatic necrosis has developed. Nowadays, the first-line treatment for walled-off pancreatic necrosis is endoscopic endoluminal transgastric necrotomy, but in extensive cases and if the wall of the necrotic cavity is too thick and cholecystectomy is also necessary, laparoscopic or open transgastric necrotomy is justified. The authors analyze the changes in surgical treatments and also cover the issues of indications for operations and surgical techniques. Orv Hetil. 2024; 165(15): 563–567. [ABSTRACT FROM AUTHOR]
- Abstract: Az akut pancreatitis sebészi kezelése az utóbbi időkben jelentősen megváltozott. A sürgősségi műtétek indikációja és sebészi technikája alapvetően hasonló a korábbi gyakorlathoz, azonban újabb indikációs terület jelent meg. Az abdominalis kompartment szindróma sürgős műtéti indikációt képez, ha a konzervatív és szemikonzervatív kezelés eredménytelen. Ilyenkor napjainkban a dekompressziós laparotomia és a negatívnyomás-terápiával kombinált nyitotthas-kezelés javasolt. A hagyományos sebészi necrosectomia helyett a minimálisan invazív sebészi kezelések terjedtek el, melyek csak a betegség késői stádiumában kialakuló, fertőzött, demarkált pancreasnecrosis esetén javasoltak. Napjainkban a demarkált necrosis első vonalbeli kezelése az endoszkópos endoluminalis transgastricus necrosectomia, de kiterjedt esetekben, és ha a necroticus üreg fala túl vastag, valamint ha cholecystectomia is szükséges, a laparoszkópos vagy nyitott transgastricus necrosectomia indokolt. A szerzők elemzik a sebészi kezelésben beállt változásokat, kitérnek a javallatok és a műtéti technika kérdéseire is. Orv Hetil. 2024; 165(15): 563–567. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of Hungarian Medical Journal / Orvosi Hetilap is the property of Akademiai Kiado and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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