نخر البنكرياس المصاب في مريض مستقر سريرياً عندما لم يؤدِّ العلاج بالمضادات الحيوية إلى حل الالتهاب

References

DOI: 10.14309/ajg.0000000000002645

• Current consensus is that surgery should be performed on clinically unstable patients with infected necrosis.
• However, in most patients, those clinically stable, the initial management of infected necrosis should be a 30-day course of antibiotics before surgery to allow the inflammatory reaction to become better organized.
• If there is no response to such antibiotics in a short time or if the clinical situation deteriorates, necrosectomy/debridement should be performed.
• Minimally invasive methods are preferred to open surgery for debridement and necrosectomy in stable patients with symptomatic pancreatic necrosis.
• We suggest delaying any intervention (surgical, radiological, and/or endoscopic) in stable patients with pancreatic necrosis, preferably 4 weeks, to allow for the wall of collection to mature.