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Intro #1 - Surgical Debridement: Necrosectomy - Acute Necrotizing Pancreatitis
The underlying pathogenetic mechanisms acting during The Course of the disease, leading to acinus cell necroses and propagation of necrotizing inflammation - Surgical Debridement: Necrosectomy - Acute Necrotizing Pancreatitis
Primary therapy of severe necrotizing pancreatitis (SNP) consists of a conservative intensive care treatment, aiming at fluid replacement, sufficient analgesia, and prevention of organ failure - Surgical Debridement: Necrosectomy - Acute Necrotizing Pancreatitis
Intro #2 - Surgical Debridement: Necrosectomy - Acute Necrotizing Pancreatitis
The operation should be undertaken as late as possible, when necroses have been ceased, viable and nonviable tissues are well demarcated, and infected necrotic tissues are “walled off” - Surgical Debridement: Necrosectomy - Acute Necrotizing Pancreatitis
Surgical therapy was indicated as a desperate attempt to reverse the disease's lethal course and lower its dramatically high mortality rates - Surgical Debridement: Necrosectomy - Acute Necrotizing Pancreatitis
Intro #3 - Surgical Debridement: Necrosectomy - Acute Necrotizing Pancreatitis
The concept of necrosectomy performed with rigorous preservation of vital pancreatic tissue can berationalized by suggesting that it accomplishes locally focused control of necrosis and pancreatogenic ascites from the lesser sac and the peritoneal cavity, which in turn interrupt the devastating progress of inflammation and the systemic release of various inflammatory mediators that account for remote organ failure - Surgical Debridement: Necrosectomy - Acute Necrotizing Pancreatitis
Necrosectomy is traditionally performed via an open route. Adequate debridement is usually achieved with a single operation. A longitudinal midline incision allows the assessment of the entire abdominal cavity, irrigation of the entire abdomen, and the performance of a diverting ileostomy provided that the necrotic process involves the retrocolic area - Surgical Debridement: Necrosectomy - Acute Necrotizing Pancreatitis
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