Therapeutic Alternatives for the Treatment of Infected Pancreatic Necrosis: An Overview

Despite diagnostic and therapeutic advances, the treatment of infected pancreatic necrosis (IPN) continues to be a complex problem to solve. The aim of this study is to evaluate the effectiveness of different surgical alternatives for the treatment of IPN. Articles published between 2000 to 2013, an...

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Autores principales:	Manterola,Carlos, Urrutia,Sebastián, Apodaca,Franz
Lenguaje:	English
Publicado:	Sociedad Chilena de Anatomía 2014
Materias:	Pancreatitis, Acute Necrotizing/complications Pancreatitis, Acute Necrotizing/therapy Infected pancreatic necrosis Necrosectomy Evidence-based medicine Overview
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0717-95022014000400037
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spelling	oai:scielo:S0717-950220140004000372015-11-16Therapeutic Alternatives for the Treatment of Infected Pancreatic Necrosis: An OverviewManterola,CarlosUrrutia,SebastiánApodaca,Franz Pancreatitis, Acute Necrotizing/complications Pancreatitis, Acute Necrotizing/therapy Infected pancreatic necrosis Necrosectomy Evidence-based medicine Overview Despite diagnostic and therapeutic advances, the treatment of infected pancreatic necrosis (IPN) continues to be a complex problem to solve. The aim of this study is to evaluate the effectiveness of different surgical alternatives for the treatment of IPN. Articles published between 2000 to 2013, and related to effectiveness of open surgery (OS) and minimally invasive treatmente (MIT) in patients with IPN were evaluated. PubMed, MEDLINE, The Cochrane Database of Systematic Reviews, Cochrane Central Register RCT, DARE, IBECS, SciELO, LILACS, PAHO, WHOLIS, ASERNIP-S, NIHR, HTA, Clinical Excellence, York Health Economic Consortium and Tripdatabase were reviewed, searching systematic reviews (SR), randomized clinical trials (RCT) and observational studies (OST), in which the effectiveness of OS and MIT was evaluated in relation to the variables mortality, intra-abdominal bleeding, development of enterocutaneous fistula or hollow viscera perforation, development of pancreatic fistula, reoperations for complications, reoperations for new necrosectomy, development of diabetes mellitus and pancreatic enzyme requirements. Three hundred eighty-nine articles were retrieved, 10 of which met the selection criteria (2 SR, 1 RCT and 7 OST). The studies have a level of evidence of 2a, 2b, 3a and 4. MIT are associated with better results than OS in all variables analyzed, but significantly only in the development of diabetes mellitus and pancreatic enzyme requirement. Articles found are few and heterogeneous, making meaningful conclusions difficult. Studies with a better level of evidence, methodological quality and population size are needed to make conclusions and recommendations.info:eu-repo/semantics/openAccessSociedad Chilena de AnatomíaInternational Journal of Morphology v.32 n.4 20142014-12-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0717-95022014000400037en10.4067/S0717-95022014000400037
institution	Scielo Chile
collection	Scielo Chile
language	English
topic	Pancreatitis, Acute Necrotizing/complications Pancreatitis, Acute Necrotizing/therapy Infected pancreatic necrosis Necrosectomy Evidence-based medicine Overview
spellingShingle	Pancreatitis, Acute Necrotizing/complications Pancreatitis, Acute Necrotizing/therapy Infected pancreatic necrosis Necrosectomy Evidence-based medicine Overview Manterola,Carlos Urrutia,Sebastián Apodaca,Franz Therapeutic Alternatives for the Treatment of Infected Pancreatic Necrosis: An Overview
description	Despite diagnostic and therapeutic advances, the treatment of infected pancreatic necrosis (IPN) continues to be a complex problem to solve. The aim of this study is to evaluate the effectiveness of different surgical alternatives for the treatment of IPN. Articles published between 2000 to 2013, and related to effectiveness of open surgery (OS) and minimally invasive treatmente (MIT) in patients with IPN were evaluated. PubMed, MEDLINE, The Cochrane Database of Systematic Reviews, Cochrane Central Register RCT, DARE, IBECS, SciELO, LILACS, PAHO, WHOLIS, ASERNIP-S, NIHR, HTA, Clinical Excellence, York Health Economic Consortium and Tripdatabase were reviewed, searching systematic reviews (SR), randomized clinical trials (RCT) and observational studies (OST), in which the effectiveness of OS and MIT was evaluated in relation to the variables mortality, intra-abdominal bleeding, development of enterocutaneous fistula or hollow viscera perforation, development of pancreatic fistula, reoperations for complications, reoperations for new necrosectomy, development of diabetes mellitus and pancreatic enzyme requirements. Three hundred eighty-nine articles were retrieved, 10 of which met the selection criteria (2 SR, 1 RCT and 7 OST). The studies have a level of evidence of 2a, 2b, 3a and 4. MIT are associated with better results than OS in all variables analyzed, but significantly only in the development of diabetes mellitus and pancreatic enzyme requirement. Articles found are few and heterogeneous, making meaningful conclusions difficult. Studies with a better level of evidence, methodological quality and population size are needed to make conclusions and recommendations.
author	Manterola,Carlos Urrutia,Sebastián Apodaca,Franz
author_facet	Manterola,Carlos Urrutia,Sebastián Apodaca,Franz
author_sort	Manterola,Carlos
title	Therapeutic Alternatives for the Treatment of Infected Pancreatic Necrosis: An Overview
title_short	Therapeutic Alternatives for the Treatment of Infected Pancreatic Necrosis: An Overview
title_full	Therapeutic Alternatives for the Treatment of Infected Pancreatic Necrosis: An Overview
title_fullStr	Therapeutic Alternatives for the Treatment of Infected Pancreatic Necrosis: An Overview
title_full_unstemmed	Therapeutic Alternatives for the Treatment of Infected Pancreatic Necrosis: An Overview
title_sort	therapeutic alternatives for the treatment of infected pancreatic necrosis: an overview
publisher	Sociedad Chilena de Anatomía
publishDate	2014
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0717-95022014000400037
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Therapeutic Alternatives for the Treatment of Infected Pancreatic Necrosis: An Overview

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