Prevention and treatment of severe acute pancreatitis com-plicated with pancreatic infection
- VernacularTitle:重症急性胰腺炎并发胰腺感染的防治
- Author:
Enqiang MAO
- Publication Type:Journal Article
- Keywords:
Pancreatic infection;
Severe acute pancreatitis;
Treatment
- From:
Chinese Journal of Digestive Surgery
2008;7(5):327-330
- CountryChina
- Language:Chinese
-
Abstract:
Pancreatic infection is an independent risk factor leading to death. Early prophylaxis, diagnosis and treat-ment are three keys to raise the survival rate. Strategies of prevention include prevention of bacteria translacation, fluid sequestration and antibiotic prophylaxis usage. The principal methods to decrease bacteria translocation are shortening of interval of intestinal iscbemia, decreasing of abdominal pressure, selective digestive decontamination and total enteral nutrition as early as possible. And strategy of controlling fluid resuscitation is the key point to decrease fluid sequestration. Early diagnostic criteria of pancreatic infection include at least 4 indexes of the following: white blood cell count, temperature, heart beat, intraabdominal pressure, procalcitonin, air bubble, blood pressure, prealbumin, total bilirubin and respiratory alkalosis, and addition of 2 weeks after the onset of the disease and exclusion of infection from other sites. If pancreatic infection has not been controlled by intensive nonoperative therapy for 48 hours, surgical intervention should be performed.
