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Together We Stand, Divided We Fall: A Multidisciplinary Approach in Complicated Acute Pancreatitis

dc.contributor.authorPaulino, J
dc.contributor.authorRamos, G
dc.contributor.authorVeloso Gomes, F
dc.date.accessioned2019-10-22T15:04:12Z
dc.date.available2019-10-22T15:04:12Z
dc.date.issued2019-10-03
dc.description.abstractAcute pancreatitis (AP) is an inflammatory condition with a mild course in most patients, but 20-30% evolve to single or multiple organ dysfunction and pancreatic/peripancreatic necrosis, with potentially infected collections. In the first weeks of disease, a systemic inflammatory syndrome (SIRS) dominates the clinical setting, and early management decisions in this precocious phase can change the course of the disease. Imaging is crucial in the diagnosis, and since the adoption of the revised Atlanta classification, four different types of pancreatic/peripancreatic collections have been defined. The management of the complicated forms of AP has been defined by several treatment guidelines, and the main indication for intervention is local infection, preferably in walled-off necrosis. Open surgery necrosectomy is associated with a very high rate of morbimortality, giving a place to different multidisciplinary methodologies, emphasizing drainage and necrosectomy techniques in a "step-up" approach starting from mini-invasive endoscopic drainage and moving, if needed, to progressively more invasive techniques, including interventional radiology and mini-invasive surgery. With the advent of several new technologies in the specialties involved, the complicated AP cases which need drainage and necrosectomy benefit from a new era of multidisciplinary cooperation, permitting higher efficacy with lower levels of morbimortality and reducing hospital stay and costs.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationJ Clin Med. 2019 Oct 3;8(10). pii: E1607.pt_PT
dc.identifier.doi10.3390/jcm8101607pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3333
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherMDPIpt_PT
dc.subjectCHLC CHBPTpt_PT
dc.subjectHSAC GASpt_PT
dc.subjectCHLC URIpt_PT
dc.subjectAcute Pancreatitispt_PT
dc.subjectInfectionpt_PT
dc.subjectHaemorrhagept_PT
dc.subjectNecrosectomypt_PT
dc.subjectDrainagept_PT
dc.titleTogether We Stand, Divided We Fall: A Multidisciplinary Approach in Complicated Acute Pancreatitispt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue10pt_PT
oaire.citation.startPage1607pt_PT
oaire.citation.titleJournal of Clinical Medicinept_PT
oaire.citation.volume8pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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