Acute pancreatitis
1. Big picture
Acute pancreatitis is a common surgical emergency, but most cases are treated non-operatively. The surgeon’s job is to:
- Confirm the diagnosis.
- Identify severity early.
- Find the cause, especially gallstones.
- Resuscitate and prevent organ failure.
- Treat biliary obstruction/cholangitis urgently.
- Avoid unnecessary early surgery.
- Intervene only for complications, especially infected necrosis, abdominal compartment syndrome, bleeding, bowel ischemia, and persistent symptomatic collections.
The key exam sentence:
Acute pancreatitis is initially a resuscitation and critical-care disease, not an immediate operative disease. Surgery is mainly for complications or for definitive prevention of recurrence in gallstone pancreatitis.
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