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Acute Pancreatitis in Children.

Steven L. Werlin1

  • 1Gastroenterology Section, Department of Pediatrics, The Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, USA. swerlin@mcw.edu

Current Treatment Options in Gastroenterology
|September 19, 2001
PubMed
Summary

Current pancreatitis treatments focus on supportive care and managing complications, as no cure exists. For severe cases, interventions like antibiotics and surgical debridement improve survival rates.

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Area of Science:

  • Gastroenterology and Hepatology
  • Surgical Gastroenterology

Background:

  • Pancreatitis lacks curative therapies, necessitating supportive and expectant management for mild to moderate cases.
  • Severe pancreatitis involves local, systemic, and septic complications requiring intensive treatment.

Purpose of the Study:

  • To outline current treatment strategies for mild, moderate, and severe pancreatitis.
  • To highlight the role of supportive care, complication management, and emerging surgical approaches.

Main Methods:

  • Supportive care: pain relief, fluid/electrolyte balance, nutritional support (enteral/parenteral feeding).
  • Interventions for biliary pancreatitis: Endoscopic retrograde cholangiopancreatography (ERCP) for stone extraction.
  • Management of severe pancreatitis: Intravenous antibiotics, selective bowel decontamination, surgical debridement, necrosectomy, and lavage.

Main Results:

  • Supportive care is the mainstay for 85% of pancreatitis cases.
  • Antibiotics and selective bowel decontamination reduce mortality in severe pancreatitis.
  • Emerging evidence suggests necrosectomy and lavage improve survival over traditional resection and drainage.

Conclusions:

  • Pancreatitis treatment is primarily supportive, focusing on homeostasis and complication management.
  • While no cure exists, interventions like antibiotics and advanced surgical techniques enhance outcomes in severe disease.
  • The consensus is shifting towards necrosectomy and lavage for improved survival in severe pancreatitis.

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