AN
Acute Necrotizing Pancreatitis
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(((intro)))
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Primary therapy of severe necrotizing pancreatitis (SNP) consists of a conservative intensive care treatment, aiming at fluid replacement, sufficient analgesia, and prevention of organ failure
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The underlying pathogenetic mechanisms acting during The Course of the disease, leading to acinus cell necroses and propagation of necrotizing inflammation
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Intro #1
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The operation should be undertaken as late as possible, when necroses have been ceased, viable and nonviable tissues are well demarcated, and infected necrotic tissues are “walled off”
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Surgical therapy was indicated as a desperate attempt to reverse the disease's lethal course and lower its dramatically high mortality rates
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The concept of necrosectomy performed with rigorous preservation of vital pancreatic tissue can berationalized by suggesting that it accomplishes locally focused control of necrosis and pancreatogenic ascites from the lesser sac and the peritoneal cavity, which in turn interrupt the devastating progress of inflammation and the systemic release of various inflammatory mediators that account for remote organ failure
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