Intra‐abdominal vacuum‐assisted closure (VAC) after necrosectomy for acute necrotising pancreatitis: preliminary experience期刊界 All Journals 搜尽天下杂志传播学术成果专业期刊搜索期刊信息化学术搜索

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Intra‐abdominal vacuum‐assisted closure (VAC) after necrosectomy for acute necrotising pancreatitis: preliminary experience

Authors:	D Sermoneta M Di Mugno PL Spada C Lodoli ME Carvelli SC Magalini C Cavicchioni MG Bocci F Martorelli MG Brizi D Gui

Institution:	1. D Sermoneta, MD, Emergency Surgery Unit, Department of Surgery, Policlinico Gemelli, Università Cattolica del Sacro Cuore, Roma, Itlay;2. M Di Mugno, MD, Emergency Surgery Unit, Department of Surgery, Policlinico Gemelli, Università Cattolica del Sacro Cuore, Roma, Itlay;3. PL Spada, MD, FACS, Emergency Surgery Unit, Department of Surgery, Policlinico Gemelli, Università Cattolica del Sacro Cuore, Roma, Itlay;4. C Lodoli, MD, Emergency Surgery Unit, Department of Surgery, Policlinico Gemelli, Università Cattolica del Sacro Cuore, Roma, Itlay;5. ME Carvelli, MD, Emergency Surgery Unit, Department of Surgery, Policlinico Gemelli, Università Cattolica del Sacro Cuore, Roma, Itlay;6. SC Magalini, MD, Emergency Surgery Unit, Department of Surgery, Policlinico Gemelli, Università Cattolica del Sacro Cuore, Roma, Itlay;7. C Cavicchioni, MD, FACS, Emergency Surgery Unit, Department of Surgery, Policlinico Gemelli, Università Cattolica del Sacro Cuore, Roma, Itlay;8. MG Bocci, MD, Intensive Care Unit, Deptartment of Anesthesiology, Policlinico Gemelli, Università Cattolica del Sacro Cuore, Roma, Itlay;9. F Martorelli, MD, Intensive Care Unit, Deptartment of Anesthesiology, Policlinico Gemelli, Università Cattolica del Sacro Cuore, Roma, Itlay;10. MG Brizi, MD, Department of Radiology, Policlinico Gemelli, Università Cattolica del Sacro Cuore, Roma, Itlay;11. D Gui, MD, FACS, Emergency Surgery Unit, Department of Surgery, Policlinico Gemelli, Università Cattolica del Sacro Cuore, Roma, Itlay

Abstract:	Infection of pancreatic necrosis, although present in less than 10% of acute pancreatitis, carries a high risk of mortality; debridment and drainage of necrosis is the treatment of choice, followed by ‘open’ or ‘close’ abdomen management. We recently introduced the use of intra‐abdominal vacuum sealing after a classic necrosectomy and laparostomy. Two patients admitted to ICU for respiratory insufficiency and a diagnosis of severe acute pancreatitis developed pancreatic necrosis and were treated by necrosectomy, lesser sac marsupialisation and posterior lumbotomic opening. Both of the patients recovered from pancreatitis and a good healing of laparostomic wounds was obtained with the use of the VAC system. Most relevant advantages of this technique seem to be: the prevention of abdominal compartment syndrome, the simplified nursing of patients and the reduction of time to definitive abdominal closure.

Keywords:	Abdominal infection Acute pancreatitis Laparostomy Negative pressure VAC

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