Medical and/or Surgical Treatment of Severe Acute Pancreatitis

Abstract

When acute pancreatitis is of the edematous type, mortality is usually less than 1% —2%. When, however, the pancreatic inflammatory response is characterized by necrosis and/or hemorrhage, mortality rises up to about 50% on average. Although, typically, the outcome of the disease is relatively unpredictable, some “package” protocols including clinical assessment and multiple laboratory criteria have gained considerable acceptance in the early diagnosis of severe acute pancreatitis [16, 27]. More recently, the additional use of initial ultrasonographic and computed tomographic findings has been suggested [4, 20] to further improve the original prognostic estimation and identification of patients in whom life-threatening complications may develop. In this review, the focus is primarily on the treatment of severe pancreatitis.