Zusammenfassung
GRUNDLAGEN: Die operative Behandlung der schweren akuten Pankreatitis geht nach wie vor mit hohen Letalitätsraten einher. Bei Vermeidung von übereilten chirurgischen Interventionen kann das Überleben der Patienten signifikant verbessert werden. METHODIK: Die Analyse sowohl der Literatur als auch der eigenen Ergebnisse führte an unserer Abteilung der Medizinischen Universität Wien zu einem konservativen Zugang in der Behandlung der schweren akuten Pankreatitis. ERGEBNISSE: Das Hinauszögern der chirurgischen Intervention bis in die dritte Krankheitswoche verbessert signifikant das Patientenüberleben. Desweiteren kann die Pankreasnekrose meist durch einen einzigen chirurgischen Eingriff suffizient entfernt werden. SCHLUSSFOLGERUNGEN: Der konservative Zugang in der Behandlung der schweren akuten Pankreatitis ist vielversprechend. Das Organversagen, vor alien Dingen in der Frühphase der Erkrankung, kann durch geeignete intensivmedizinische Verfahren adäquat behandeit werden.
Summary
BACKGROUND: Operative treatment of severe acute pancreatitis is still related to high mortality rates. By avoiding early surgical intervention patient survival may be significantly improved. METHODS: Review both of the literature as well as of own results has led to a conservative approach in severe acute pancreatitis at the surgical department of the Medical University Vienna. RESULTS: Delaying surgery up to the third week after onset of disease improves patient survival significantly. Moreover, surgical control of pancreatic necrosis can be achieved by a single operation. CONCLUSIONS: The conservative approach in severe acute pancreatitis is a promising therapeutic conception. Organ failure during the early phase of disease can be successfully managed by means of intensive care treatment.
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Götzinger, P. Operative treatment of severe acute pancreatitis. Eur Surg 39, 325–329 (2007). https://doi.org/10.1007/s10353-007-0371-z
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DOI: https://doi.org/10.1007/s10353-007-0371-z