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Open Abdomen pp 101-107 | Cite as

Open Abdomen in Acute Pancreatitis

  • Ari Leppäniemi
Chapter
Part of the Hot Topics in Acute Care Surgery and Trauma book series (HTACST)

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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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Abdominal SurgeryMeilahti Hospital, University of HelsinkiHelsinkiFinland

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