Interventional Treatment of Abdominal Compartment Syndrome during Severe Acute Pancreatitis: Current Status and Historical Perspective
Abdominal compartment syndrome (ACS) in patients with severe acute pancreatitis (SAP) is a marker of severe disease. It occurs as combination of inflammation of retroperitoneum, visceral edema, ascites, acute peripancreatic fluid collections, paralytic ileus, and aggressive fluid resuscitation. The...
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Wiley
2016-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2016/5251806 |
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| author | Dejan V. Radenkovic Colin D. Johnson Natasa Milic Pavle Gregoric Nenad Ivancevic Mihailo Bezmarevic Dragoljub Bilanovic Vladimir Cijan Andrija Antic Djordje Bajec |
| author_facet | Dejan V. Radenkovic Colin D. Johnson Natasa Milic Pavle Gregoric Nenad Ivancevic Mihailo Bezmarevic Dragoljub Bilanovic Vladimir Cijan Andrija Antic Djordje Bajec |
| author_sort | Dejan V. Radenkovic |
| collection | DOAJ |
| description | Abdominal compartment syndrome (ACS) in patients with severe acute pancreatitis (SAP) is a marker of severe disease. It occurs as combination of inflammation of retroperitoneum, visceral edema, ascites, acute peripancreatic fluid collections, paralytic ileus, and aggressive fluid resuscitation. The frequency of ACS in SAP may be rising due to more aggressive fluid resuscitation, a trend towards conservative treatment, and attempts to use a minimally invasive approach. There remains uncertainty about the most appropriate surgical technique for the treatment of ACS in SAP. Some unresolved questions remain including medical treatment, indications, timing, and interventional techniques. This review will focus on interventional treatment of this serious condition. First line therapy is conservative treatment aiming to decrease IAP and to restore organ dysfunction. If nonoperative measures are not effective, early abdominal decompression is mandatory. Midline laparostomy seems to be method of choice. Since it carries significant morbidity we need randomized studies to establish firm advantages over other described techniques. After ACS resolves efforts should be made to achieve early primary fascia closure. Additional data are necessary to resolve uncertainties regarding ideal timing and indication for operative treatment. |
| format | Article |
| id | doaj-art-14b51a24062444bf9d49fd6b047b2889 |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-14b51a24062444bf9d49fd6b047b28892025-02-03T05:53:45ZengWileyGastroenterology Research and Practice1687-61211687-630X2016-01-01201610.1155/2016/52518065251806Interventional Treatment of Abdominal Compartment Syndrome during Severe Acute Pancreatitis: Current Status and Historical PerspectiveDejan V. Radenkovic0Colin D. Johnson1Natasa Milic2Pavle Gregoric3Nenad Ivancevic4Mihailo Bezmarevic5Dragoljub Bilanovic6Vladimir Cijan7Andrija Antic8Djordje Bajec9Clinic for Digestive Surgery, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, SerbiaDepartment of Surgery, University Hospital Southampton, Southampton, UKInstitute for Biostatistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, SerbiaClinic for Emergency Surgery, Emergency Center, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, SerbiaClinic for Emergency Surgery, Emergency Center, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, SerbiaClinic for Surgery, Military Medical Academy, Belgrade, SerbiaClinic for Surgery, Clinical Center “Bezanijska Kosa”, Faculty of Medicine, University of Belgrade, Belgrade, SerbiaClinic for Surgery, Clinical Center “Zvezdara”, Belgrade, SerbiaClinic for Digestive Surgery, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, SerbiaClinic for Digestive Surgery, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, SerbiaAbdominal compartment syndrome (ACS) in patients with severe acute pancreatitis (SAP) is a marker of severe disease. It occurs as combination of inflammation of retroperitoneum, visceral edema, ascites, acute peripancreatic fluid collections, paralytic ileus, and aggressive fluid resuscitation. The frequency of ACS in SAP may be rising due to more aggressive fluid resuscitation, a trend towards conservative treatment, and attempts to use a minimally invasive approach. There remains uncertainty about the most appropriate surgical technique for the treatment of ACS in SAP. Some unresolved questions remain including medical treatment, indications, timing, and interventional techniques. This review will focus on interventional treatment of this serious condition. First line therapy is conservative treatment aiming to decrease IAP and to restore organ dysfunction. If nonoperative measures are not effective, early abdominal decompression is mandatory. Midline laparostomy seems to be method of choice. Since it carries significant morbidity we need randomized studies to establish firm advantages over other described techniques. After ACS resolves efforts should be made to achieve early primary fascia closure. Additional data are necessary to resolve uncertainties regarding ideal timing and indication for operative treatment.http://dx.doi.org/10.1155/2016/5251806 |
| spellingShingle | Dejan V. Radenkovic Colin D. Johnson Natasa Milic Pavle Gregoric Nenad Ivancevic Mihailo Bezmarevic Dragoljub Bilanovic Vladimir Cijan Andrija Antic Djordje Bajec Interventional Treatment of Abdominal Compartment Syndrome during Severe Acute Pancreatitis: Current Status and Historical Perspective Gastroenterology Research and Practice |
| title | Interventional Treatment of Abdominal Compartment Syndrome during Severe Acute Pancreatitis: Current Status and Historical Perspective |
| title_full | Interventional Treatment of Abdominal Compartment Syndrome during Severe Acute Pancreatitis: Current Status and Historical Perspective |
| title_fullStr | Interventional Treatment of Abdominal Compartment Syndrome during Severe Acute Pancreatitis: Current Status and Historical Perspective |
| title_full_unstemmed | Interventional Treatment of Abdominal Compartment Syndrome during Severe Acute Pancreatitis: Current Status and Historical Perspective |
| title_short | Interventional Treatment of Abdominal Compartment Syndrome during Severe Acute Pancreatitis: Current Status and Historical Perspective |
| title_sort | interventional treatment of abdominal compartment syndrome during severe acute pancreatitis current status and historical perspective |
| url | http://dx.doi.org/10.1155/2016/5251806 |
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