ArticleHPB : the official journal of the International Hepato Pancreato Biliary Association2008
Conservative approach in the management of severe acute pancreatitis: eight-year experience in a single institution.
Article in HPB : the official journal of the International Hepato Pancreato Biliary Association, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed, 25 citations in OpenAlex.
- Article
- Fluid resuscitation in acute pancreatitis.World journal of gastroenterology · 2014Review
- Audit of patients with severe acute pancreatitis admitted to an intensive care unit.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2012Article
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Authors and funding
4 authors at 1 institution in 1 country.
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Abstract
introductionRecognition of severe acute pancreatitis (SAP), intensive care, shifting away from early surgical treatment, and monitoring of the intra-abdominal pressure (IAP) is important in the management of SAP. The aim of our study was retrospective evaluation and critical assessment of the experience with SAP management protocol involving new strategy in the university hospital.
methodsProtocols of 274 SAP patients treated in our institution during the last eight years were reassessed. APACHE II, CRP and SOFA score, IAP, pulmonary complications, ventilatory support and infection rate were evaluated. The success of the conservative treatment, surgical interventions and mortality was analysed comparing period 1 from 1999 to 2002 and period 2 from 2003 to 2006.
resultsMore patients with necrotising SAP were treated in period 2. The average CRP and SOFA score was higher in period 2, p=0.018; p=0.011. A total of 139 patients underwent continuous veno-venous haemofiltration (CVVH) as a component of fluid resuscitation and IAP control. Application of CVVH increased in period 2, p<0.005. Only 5-8% of patients were managed with ventilatory support. The overall infection rate decreased in period 2 comprising 21%, p<0.005. Success rate of the conservative therapy reached 69% in period 2, p<0.01. Surgical treatment was performed in 41% of patients in period 1 vs. 19% in period 2, p<0.001. Overall mortality was 19%, with a reduction to 12% in year 2006.
conclusionThe conservative protocol-based approach is a rational treatment strategy for the management of SAP and can be successfully implemented in the setting of the university hospital.
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