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Acute Pancreatitis Treatment

Acute Pancreatitis Treatment

The goal in treating acute pancreatitis is to allow the pancreas to rest and recover from the inflammation. You may need fluid replacement and nutritional support as your body recovers.

Treatment includes:

Endoscopic Therapy

  • Endoscopic therapy helps treat three specific areas of acute pancreatitis:

  • Acute gallstone pancreatitis. Gallstones in your bile duct are causing the pancreatic inflammation. Your doctor performs an endoscopy to remove the gallstones.

  • Recurrent pancreatitis with pancreatic sphincter dysfunction. Due to better diagnostic testing, doctors now understand that many cases of recurrent pancreatitis are due to a pancreatic sphincter dysfunction. We may perform an endoscopic pancreatic sphincterotomy to cut the sphincter muscle.

  • Recurrent pancreatitis due to pancreas divisum. Pancreas divisum is a condition in which the two parts of your pancreas do not join together. We may perform an endoscopic minor papilla sphincterotomy to repair this. This is similar to an endoscopic pancreatic sphincterotomy.

     

    See illustration: Endoscopic biliary sphincterotomy with stone removal.

Acute Pancreatitis Treatment: Surgery

  • Resecting (removing) the diseased pancreatic tissue, depending on the severity of your condition.

  • Cholecystectomy : Removing the gallbladder may be effective if you have recurrent acute pancreatitis.

  • Surgical sphincteroplasty of the pancreatic sphincter, a procedure that reconstructs your pancreatic sphincter muscle.

    A, B: Technique of cholecystectomy with A’, B’: laparoscopic view.
    A, B: Technique of cholecystectomy with A’, B’: laparoscopic view. (Click to Enlarge)

Acute Pancreatitis: Complications

In patients with severe pancreatitis, complications may develop that affect other organs in the body. These systemic problems can involve the pulmonary system, kidneys, stomach and colon. Severe pancreatitis can also cause local complications, including:

  • Fluid collection . Fluid collection is common in patients with acute pancreatitis. If it is simple fluid, the problem usually resolves spontaneously and no treatment is required. If we see gas as well, you may have an underlying infection that needs treatment.

  • Pseudocysts. When pancreatic juices collect outside the body's ductal system, it results in pseudocysts. Most resolve spontaneously. Larger cysts require treatment. We may drain the cyst or surgically remove it.

  • Pancreatic necrosis . Necrosis is premature cell death.Pancreatic necrosis is a significant complication that can be life threatening. Your doctor can diagnose pancreatic necrosis using a contrast-enhanced CT scan. Treatment usually involves debriding (surgically removing the dead tissue) or draining the tissue.

  • Pulmonary involvement . If you accumulate a large amount of fluid, it may compress your lungs and lead to respiratory distress syndrome.

  • Other complications include renal (kidney) dysfunction and gastrointestinal hemorrhage.

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