Portal de Periódicos da CAPES

Abstracts

2012; Elsevier BV; Volume: 14; Linguagem: Inglês

10.1111/j.1477-2574.2012.00437.x

1477-2574

Alain Abdo, Niraj Jani, Sean Cunningham, Yoko Abe, Kiminori Takano, Motohide Shimazu, Mohammed Hilal, Sohail Syed, Robert Wiltshire, F Difabio, Neil Pearce, John Primrose, Fernando A. Alvarez, José Iniesta, Esteban Sieling, Juan Pekolj, E De Santibanes, Albert Amini, B. Banerjee, Alejandro Garcia‐Uribe, Jun Zou, Linghua Wang, Andrew R. Rouse, Arthur F. Gmitro, Tun Jie, Rainer W.G. Gruessner, Evelyn Ong, John B. Ammori, Nancy Kemeny, Yuman Fong, Andrea Cercek, Ronald P. DeMatteo, Penny Allen, Philip B. Paty, William R. Jarnagin, M D'angelica, J. Anderson, Kristin L. Mekeel, David C. Chang, Mark A. Talamini, Alan W. Hemming, Annamalai Arunachalam, Vinod Menon, V.N. Puri, Catherine Bresee, Brendan Boland, Allan L. Klein, Jeffrey H. Fair,

Pancreatic duct disruption may be challenging to manage, with diverse etiologies and sequelae in a heterogeneous population.Common etiologies include pancreatitis, iatrogenic injury, and trauma, and common sequelae of pancreatic duct disruption include pseudocyst, pancreatic ascites, and fi stulae.Although general principles, such as pancreas rest and nutritional support are generally agreed upon, no universal consensus exists regarding which specifi c treatment strategies are best and in which order.Some pancreatologists favor, for example, immediate NPO status vs oral diet as tolerated, octreotide vs no octreotide, endoscopic pancreatic duct stenting versus no stent.The more aggressive (ie, the former) of each of these treatment options is favored by the authors, who have found that a less aggressive approach using slower, stepwise initiation of progressively aggressive treatments simply delays resolution of pancreatic duct disruption.In our experience, strict and immediate NPO status with IV nutrition, immediate use of octreotide, aggressive image-guided percutaneous catheter drainage, and early endoscopic stenting of the pancreatic duct seem, anecdotally, in patients stratifi ed as having persistent, refractory, or otherwise severe duct disruption, to have a high success rate in leading to the fast resolution of pancreatic duct disruption.