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Open Abdomen in Acute Pancreatitis

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Open Abdomen

Part of the book series: Hot Topics in Acute Care Surgery and Trauma ((HTACST))

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Abstract

Leaving the abdomen open can be a prophylactic or therapeutic procedure, and in patients with severe acute pancreatitis, it can be used in potentially two kinds of situations: managing abdominal compartment syndrome and after transabdominal anterior surgical necrosectomy to facilitate drainage. While there is growing support in the literature for the first indication, open abdomen after necrosectomy is not warranted. Abdominal compartment syndrome resistant to nonoperative management including percutaneous drainage of pancreatic ascites usually requires surgical decompression. It should be performed early, and it is an effective way to decrease intra-abdominal pressure. Of the temporary abdominal closure techniques currently available, the mesh-mediated vacuum-assisted closure combining the mechanical traction of a temporary mesh with the negative pressure effect is associated with the highest fascial closure rate and lowest incidence of enteric fistulae.

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Authors and Affiliations

  1. Department of Abdominal Surgery, Meilahti Hospital, University of Helsinki, Haartmaninkatu 4, P.O. Box 340, 00029 HUS, Helsinki, Finland

    Ari Leppäniemi

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  1. Ari Leppäniemi
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Correspondence to Ari Leppäniemi .

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Editors and Affiliations

  1. General, Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena, Italy

    Federico Coccolini

  2. General Surgery, Virginia Commonvealth University, Richmond, Virginia, USA

    Rao Ivatury

  3. Letterkenny General Hospital, Letterkenny, Donegal, Ireland

    Michael Sugrue

  4. General, Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena, Italy

    Luca Ansaloni

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Leppäniemi, A. (2018). Open Abdomen in Acute Pancreatitis. In: Coccolini, F., Ivatury, R., Sugrue, M., Ansaloni, L. (eds) Open Abdomen. Hot Topics in Acute Care Surgery and Trauma. Springer, Cham. https://doi.org/10.1007/978-3-319-48072-5_8

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  • DOI: https://doi.org/10.1007/978-3-319-48072-5_8

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-48071-8

  • Online ISBN: 978-3-319-48072-5

  • eBook Packages: MedicineMedicine (R0)

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