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dc.contributor.authorRobin Valle de Lersundi, Álvaro 
dc.contributor.authorAbella Álvarez, Ana
dc.contributor.authorSan Miguel Méndez, Carlos
dc.contributor.authorMoreno Elalo-Olaso, Almudena
dc.contributor.authorCruz Cidoncha, Arturo
dc.contributor.authorAguilera Velardo, Asunción
dc.contributor.authorGordo Vidal, Federico 
dc.contributor.authorGarcía Ureña, Miguel Ángel 
dc.date.accessioned2020-07-14T09:43:18Z
dc.date.available2020-07-14T09:43:18Z
dc.date.issued2019
dc.identifier.issn0364-2313spa
dc.identifier.urihttp://hdl.handle.net/10641/1949
dc.description.abstractBackground Up to 25% of patients with acute pancreatitis develop severe complications and are classified as severe pancreatitis with a high death rate. To improve outcomes, patients may require interventional measures including surgical procedures. Multidisciplinary approach and best practice guidelines are important to decrease mortality. Methods We have conducted a retrospective analysis from a prospectively maintained database in a low-volume hospital. A total of 1075 patients were attended for acute pancreatitis over a ten-year period. We have analysed 44 patients meeting the criteria for severe acute pancreatitis and for intensive care unit (ICU) admittance. Demographics and clinical data were analysed. Patients were treated according to international guidelines and a multidisciplinary flowchart for acute pancreatitis and a step-up approach for pancreatic necrosis. Results Forty-four patients were admitted to the ICU due to severe acute pancreatitis. Twenty-five patients needed percutaneous drainage of peri-pancreatic or abdominal fluid collections or cholecystitis. Eight patients underwent endoscopic retrograde cholangiopancreatography for choledocholithiasis and biliary sepsis or pancreatic leakage, and one patient received endoscopic trans-gastric endoscopic prosthesis for pancreatic necrosis. Sixteen patients underwent surgery: six patients for septic abdomen, four patients for pancreatic necrosis and two patients due to abdominal compartment syndrome. Four patients had a combination of surgical procedures for pancreatic necrosis and for abdominal compartment syndrome. Overall mortality was 9.1%. Conclusion Severe acute pancreatitis represents a complex pathology that requires a multidisciplinary approach. Establishing best practice treatments and evidence-based guidelines for severe acute pancreatitis may improve outcomes in low-volume hospitals.spa
dc.language.isoengspa
dc.publisherWorld Journal of Surgeryspa
dc.rightsAtribución-NoComercial-SinDerivadas 3.0 España*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/3.0/es/*
dc.titleMultidisciplinary Approach to Treating Severe Acute Pancreatitis in a Low-Volume Hospital.spa
dc.typearticlespa
dc.description.versionpre-printspa
dc.rights.accessRightsopenAccessspa
dc.description.extent158 KBspa
dc.identifier.doi10.1007/s00268-019-05114-8spa
dc.relation.publisherversionhttps://link.springer.com/article/10.1007/s00268-019-05114-8#citeasspa


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