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Dtsch Med Wochenschr 2008; 133(38): 1911-1916
DOI: 10.1055/s-0028-1085576
Übersicht | Review article
Gastroenterologie
© Georg Thieme Verlag KG Stuttgart · New York

Internistische Therapie der akuten Pankreatitis

Conservative treatment of acute pancreatitisJ. Mayerle1 , C.-D Heidecke2 , M. Kraft1 , M. M. Lerch2
  • 1Klinik für Innere Medizin A, Universitätsklinikum Greifswald
  • 2Chirurgische Klinik, Abt. für Allgemein-, Viszeral-, Thorax- und Gefäßchirurgie, Universitätsklinikum Greifswald
Further Information

Publication History

eingereicht: 1.5.2008

akzeptiert: 21.8.2008

Publication Date:
10 September 2008 (online)

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Schlüsselwörter

akute Pankreatitis - enterale Ernährung - Antibiotikatherapie - Analgetikatherapie - Flüssigkeitssubstitution - prognostische Faktoren

Key words

acute pancreatitis - enteral nutrition - antibiotic treatment - prognostic factors - volume substitution - analgetic therapy

Literatur

  • 1 UK guidelines for the management of acute pancreatitis.  Gut. 2005;  54 Suppl 3 iii1-9
    Search in Google Scholar
  • 2 Andersen V, Sonne J, Andersen M. Spontaneous reports on drug-induced pancreatitis in Denmark from 1968 to 1999.  Europ J Clin Pharmacol. 2001;  57 517-521
    Search in Google Scholar
  • 3 Bai Y, Gao J, Zou D W, Li Z S. Prophylactic antibiotics cannot reduce infected pancreatic necrosis and mortality in acute necrotizing pancreatitis.  Amer J Gastroenterol. 2008;  103 104-110
    Search in Google Scholar
  • 4 Bassi C, Pederzoli P, Vesentini S, Falconi M, Bonora A, Abbas H, Benini A, Bertazzoni E M. Behavior of antibiotics during human necrotizing pancreatitis.  Antimicrob Agents Chemother. 1994;  38 830-836
    Search in Google Scholar
  • 5 Beger H G, Bittner R, Block S, Büchler M. Bacterial contamination of pancreatic necrosis.  Gastroenterology. 1986;  91 433-438
    Search in Google Scholar
  • 6 Besselink M G, van Santvoort H C, Buskens E. et al . Probiotic prophylaxis in predicted severe acute pancreatitis.  Lancet. 2008;  371 651-659
    Search in Google Scholar
  • 7 Besselink M G, van Santvoort H C, Nieuwenhuijs V B. et al . Minimally invasive ‘step-up approach’ versus maximal necrosectomy in patients with acute necrotising pancreatitis (PANTER trial).  BMC Surg. 2006;  6 6
    Search in Google Scholar
  • 8 Brown A, Orav J, Banks P A. Hemoconcentration is an early marker for organ failure and necrotizing pancreatitis.  Pancreas. 2000;  20 367-372
    Search in Google Scholar
  • 9 Büchler M, Malfertheiner P, Schoetensack C, Uhl W, Scherbaum W, Beger H G. [Value of biochemical and imaging procedures for the diagnosis and prognosis of acute pancreatitis].  Z Gastroenterol. 1986;  24 100-109
    Search in Google Scholar
  • 10 Connor S, Alexakis N, Raraty M G, Ghaneh P, Evans J, Hughes M, Garvey C J, Sutton R, Neoptolemos J P. Early and late complications after pancreatic necrosectomy.  Surgery. 2005;  137 499-505
    Search in Google Scholar
  • 11 Dellinger E P, Tellado J M, Soto N E. et al . Early antibiotic treatment for severe acute necrotizing pancreatitis: a randomized, double-blind, placebo-controlled study.  Ann Surg. 2007;  245 674-683
    Search in Google Scholar
  • 12 Disario J A, Freeman M L, Bjorkman D J. et al . Endoscopic balloon dilation compared with sphincterotomy for extraction of bile duct stones.  Gastroenterology. 2004;  127 1291-1299
    Search in Google Scholar
  • 13 Eatock F C, Brombacher G D, Steven A, Imrie C W, McKay C J, Carter R. Nasogastric feeding in severe acute pancreatitis may be practical and safe.  Int J Pancreatol. 2000;  28 23-29
    Search in Google Scholar
  • 14 Eckerwall G E, Tingstedt B B, Bergenzaun P E, Andersson R G. Immediate oral feeding in patients with mild acute pancreatitis is safe and may accelerate recovery.  Clin Nutr. 2007;  26 758-763
    Search in Google Scholar
  • 15 Eland I A, van Puijenbroek E P, Sturkenboom M J, Wilson J H, Stricker B H. Drug-associated acute pancreatitis: twenty-one years of spontaneous reporting in The Netherlands.  Amer J Gastroenterol. 1999;  94 2417-2422
    Search in Google Scholar
  • 16 Fan S T, Lai E C, Mok F P. et al . Early treatment of acute biliary pancreatitis by endoscopic papillotomy.  N Engl J Med. 1993;  328 228-232
    Search in Google Scholar
  • 17 Farkas G, Marton J, Mandi Y, Szederkenyi E, Balogh A. Progress in the management and treatment of infected pancreatic necrosis.  Scand J Gastroenterol Suppl. 1998;  228 31-37
    Search in Google Scholar
  • 18 Fölsch U R, Nitsche R, Lüdtke R, Hilgers R A, Creutzfeldt W. Early ERCP and papillotomy compared with conservative treatment for acute biliary pancreatitis.   N Engl J Med. 1997;  336 237-242
    Search in Google Scholar
  • 19 Gan S I, Romagnuolo J. Admission hematocrit: a simple, useful and early predictor of severe pancreatitis.  Dig Dis Sci. 2004;  49 1946-1952
    Search in Google Scholar
  • 20 Gerzof S G, Robbins A H, Johnson W C, Birkett D H, Nabseth D C. Percutaneous catheter drainage of abdominal abscesses.  N Engl J Med. 1981;  305 653-657
    Search in Google Scholar
  • 21 Harrison D A, D’Amico G, Singer M. Case mix, outcome, and activity for admissions to UK critical care units with severe acute pancreatitis.  Crit Care. 2007;  11 Suppl. 1 S1
    Search in Google Scholar
  • 22 Imrie C W, Carter C R, McKay C J. Enteral and parenteral nutrition in acute pancreatitis.  Best Practice Res. 2002;  16 391-397
    Search in Google Scholar
  • 23 Johnson C D, Abu-Hilal M. Persistent organ failure during the first week as a marker of fatal outcome in acute pancreatitis.  Gut. 2004;  53 1340-1344
    Search in Google Scholar
  • 24 Kahl S, Zimmermann S, Pross M, Schulz H U, Schmidt U, Malfertheiner P. Procaine hydrochloride fails to relieve pain in patients with acute pancreatitis.  Digestion. 2004;  69 5-9
    Search in Google Scholar
  • 25 Kelly T R, Swaney P E. Gallstone pancreatitis: the second time around.  Surgery. 1982;  92 571-575
    Search in Google Scholar
  • 26 Lankisch P G, Droge M, Gottesleben F. Drug induced acute pancreatitis: incidence and severity.  Gut. 1995;  37 565-567
    Search in Google Scholar
  • 27 Lankisch P G, Mahlke R, Blum T, Bruns A, Bruns D, Maisonneuve P, Lowenfels A B. Hemoconcentration: an early marker of severe and/or necrotizing pancreatitis?.  Amer J Gastroenterol. 2001;  96 2081-2085
    Search in Google Scholar
  • 28 Lerch M M. No more intravenous procaine for pancreatitis pain?.  Digestion. 2004;  69 2-4
    Search in Google Scholar
  • 29 Levy P, Heresbach D, Pariente E A. et al . Frequency and risk factors of recurrent pain during refeeding in patients with acute pancreatitis.  Gut. 1997;  40 262-266
    Search in Google Scholar
  • 30 Mayerle J, Hlouschek V, Lerch M M. Current management of acute pancreatitis.  Nature Clin Pract. 2005;  2 473-483
    Search in Google Scholar
  • 31 Mier J, Leon E L, Castillo A, Robledo F, Blanco R. Early versus late necrosectomy in severe necrotizing pancreatitis.  Amer J Surg. 1997;  173 71-75
    Search in Google Scholar
  • 32 Mofidi R, Duff M D, Wigmore S J, Madhavan K K, Garden O J, Parks R W. Association between early systemic inflammatory response, severity of multiorgan dysfunction and death in acute pancreatitis.  Brit J Surg. 2006;  93 738-744
    Search in Google Scholar
  • 33 Neoptolemos J P, Carr-Locke D L, London N J. et al . Controlled trial of urgent endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy versus conservative treatment for acute pancreatitis due to gallstones.  Lancet. 1988;  2 979-983
    Search in Google Scholar
  • 34 Nieuwenhuijs V B, Besselink M G, van Minnen L P, Gooszen H G. Surgical management of acute necrotizing pancreatitis.  Scand J Gastroenterol. 2003;  Suppl. 111-116
    Search in Google Scholar
  • 35 Olah A, Pardavi G. et al . Early nasojejunal feeding in acute pancreatitis is associated with a lower complication rate.  Nutrition. 2002;  18 259-262
    Search in Google Scholar
  • 36 Petrov M S, van Santvoort H C, Besselink M G. et al . Oral refeeding after onset of acute pancreatitis.  Amer J Gastroenterol. 2007;  102 2079-2084; quiz 2085
    Search in Google Scholar
  • 37 Raczynski S, Teich N, Borte G, Wittenburg H, Mössner J, Caca K. Percutaneous transgastric irrigation drainage in combination with endoscopic necrosectomy in necrotizing pancreatitis.  Gastroint Endosc. 2006;  64 420-424
    Search in Google Scholar
  • 38 Rau B M, Kemppainen E A, Gumbs A A, Büchler M W, Wegscheider K. et al . Early assessment of pancreatic infections and overall prognosis in severe acute pancreatitis by procalcitonin (PCT).  Ann Surg. 2007;  245 745-754
    Search in Google Scholar
  • 39 Runzi M, Niebel W, Goebell H, Gerken G, Layer P. Severe acute pancreatitis: nonsurgical treatment of infected necroses.  Pancreas. 2005;  30 195-199
    Search in Google Scholar
  • 40 Sand J, Nordback I. Probiotics in severe acute pancreatitis.  Lancet. 2008;  371 634-635
    Search in Google Scholar
  • 41 Seewald S, Groth S, Omar S. et al . Aggressive endoscopic therapy for pancreatic necrosis and pancreatic abscess.  Gastroint Endosc. 2005;  62 92-100
    Search in Google Scholar
  • 42 Seifert H, Wehrmann T, Schmitt T, Zeuzem S, Caspary W F. Retroperitoneal endoscopic debridement for infected peripancreatic necrosis.  Lancet. 2000;  356 653-655
    Search in Google Scholar
  • 43 Shafiq N, Malhotra S, Bhasin D K, Rana S, Siddhu S, Pandhi P. Estimating the diagnostic accuracy of procalcitonin as a marker of the severity of acute pancreatitis.  J Pancreas. 2005;  6 231-237
    Search in Google Scholar
  • 44 Sharma V K, Howden C W. Metaanalysis of randomized controlled trials of endoscopic retrograde cholangiography and endoscopic sphincterotomy for the treatment of acute biliary pancreatitis.  Amer J Gastroenterol. 1999;  94 3211-3214
    Search in Google Scholar
  • 45 Thorboll J, Vilmann P, Jacobsen B, Hassan H. Endoscopic ultrasonography in detection of cholelithiasis in patients with biliary pain and negative transabdominal ultrasonography.  Scand J Gastroenterol. 2004;  39 267-269
    Search in Google Scholar
  • 46 Trapnell J E, Duncan E H. Patterns of incidence in acute pancreatitis.  Brit Med J. 1975;  2 179-183
    Search in Google Scholar
  • 47 Trivedi C D, Pitchumoni C S. Drug-induced pancreatitis: an update.  J Clin Gastroenterol. 2005;  39 709-716
    Search in Google Scholar
  • 48 Vazquez-Lglesias J L, Gonzalez-Conde B, Lopez-Roses L. et al . Endoscopic sphincterotomy for prevention of the recurrence of acute biliary pancreatitis in patients with gallbladder in situ.  Surg Endosc. 2004;  18 1442-1446
    Search in Google Scholar
  • 49 Werner J, Feuerbach S, Uhl W, Büchler M W. Management of acute pancreatitis: from surgery to interventional intensive care.  Gut. 2005;  54 426-436
    Search in Google Scholar
  • 50 Xu T, Cai Q. Prophylactic antibiotic treatment in acute necrotizing pancreatitis.  Scand J Gastroenterol. 2008;  , ;Epub ahead of print
    Search in Google Scholar

Prof. Dr. Markus M. Lerch

Direktor der Klinik und Poliklinik für Innere Medizin A, Universitätsklinikum Greifswald

Friedrich-Loeffler-Str. 23A

17475 Greifswald

Phone: 03834/86-7230

Fax: 03834/86-7234

Email: lerch@uni-greifswald.de