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Query: UMLS:C0030305 (pancreatitis)
 16,014 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In the past two decades, there have been great changes regarding the policy for treating acute pancreatitis. The aim of this study was to examine the chronological changes in the management of acute pancreatitis in a tertiary referral center. A retrospective review was carried out of the management approaches for acute pancreatitis in the 15 years since 1984. The patients were divided into groups according to the admission date, representing two periods: period 1, from 1984 through 1992; and period 2, from 1993 through 1999. Decision-making for treating acute pancreatitis was based mainly on Beger's criteria. The background features and treatment outcome were compared between the two periods. The severity of pancreatitis was based on the Atlanta classification system. Octreotide was available from January 1993. No differences could be found between the two periods regarding the patients' background characteristics or severity of pancreatitis. Patients in period 2 had a longer interval between the onset of pancreatitis and surgery, and a lower incidence of pancreatectomy. Although the surgical morbidity, mortality, and reoperation rates were not significantly different between the two periods, more patients with severe acute pancreatitis in period 2 received nonsurgical treatment, and a lower mortality rate was also noted. With improvements in critical care, increasing experience, and better surgical techniques, even patients with severe acute pancreatitis can be treated by nonsurgical means. However, aggressive surgical intervention is necessary for patients who have signs of infected necrosis and whose disease is not controllable by conservative methods.
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PMID:Management of acute pancreatitis: results of a 15-year experience in Taiwan. 1145 80

Indication for emergency ERCP (< 48 hours after onset of symptoms) with stone extraction from the common bile duct (CBD) in patients with biliary pancreatitis remains controversial. In our hospital emergency ERCP with stone extraction from CBD is part of the therapeutical concept in patients with biliary pancreatitis. The aim of the study was to elucidate retrospectively results and impact of this concept on morbidity and lethality in surgical intensive care patients. We included all patients with a documented indication for emergency ERCP. Among 4 466 patients (1. 1. 1999-31. 12. 2000) treated in the SICU, 37 (0.9 %) required an emergency ERCP due to a biliary pancreatitis. (26 females/11 males, 62.0 +/- 15.4 years). After ERCP stones were present in 32 of the 37 patients with subsequent successful endoscopic extraction in all cases but one. The mean duration from admission to ERCP was 11.6 +/- 10.1 hours. Bilirubin as well as amylase and lipase decreased after ERCP (p < 0.05). Only in one case an elevation of pancreatic enzymes over the pre-ERCP values was observed, an aggravation of pancreatitis was not seen in our series. In 5 of the 37 cases bile duct stones were not found after ERCP despite strong clinical suggestion (elevation of bilirubin and pancreatic enzymes, ultrasound). During the observational period 2 patients died, in one case possibly due to the ERCP. Emergency ERCP removed in our series the pancreatitis causing agent. Still considering the limitations of a retrospective study these positive results are stimulating us to continue with our therapeutical concept.
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PMID:[Results of emergency ERCP in the treatment of acute biliary pancreatitis]. 1222 61