TY  - JOUR
T1  - SUrgical decompression for abdominal compartment syndrome in severe acute pancreatitis
AU  - Mentula P, Hienonen P, Kemppainen E, Puolakkainen P, Leppäniemi A
Y1  - 2010/08/01
N1  - 10.1001/archsurg.2010.132
JO  - Archives of Surgery
SP  - 764
EP  - 769
VL  - 145
IS  - 8
N2  - Hypothesis 
    In patients with severe acute pancreatitis and abdominal compartment syndrome, establishment of the indications and optimal time for surgical decompression may avoid exacerbation of multiple-organ dysfunction syndrome.Design 
    Retrospective study.Setting 
    Tertiary care university teaching hospital.Patients 
    Twenty-six consecutive patients with severe acute pancreatitis and abdominal compartment syndrome treated by surgical decompression between January 1, 2002, and December 31, 2007.Intervention 
    Surgical decompression of the abdomen.Main Outcome Measures 
    Morbidity, mortality, and organ dysfunction before and after surgical decompression.Results 
    At the time of surgical decompression, the median sequential organ failure assessment score among patients was 12 (interquartile range, 10-15), and the median intra-abdominal pressure was 31.5 (interquartile range, 27-35) mm Hg. After surgical decompression, renal or respiratory function was improved in 14 patients (54%). The overall hospital mortality was 46%, but mortality was 18% among 17 patients in whom surgical decompression was performed within the first 4 days after disease onset.Conclusions 
    Patients with severe acute pancreatitis and abdominal compartment syndrome managed by surgical decompression had severe multiple-organ dysfunction syndrome and high mortality. Surgical decompression may improve renal or respiratory function. Early surgical decompression is associated with reduced mortality in patients with severe acute pancreatitis, early multiple-organ dysfunction syndrome, and abdominal compartment syndrome.
SN  - 0004-0010
M3  - doi: 10.1001/archsurg.2010.132
UR  - http://dx.doi.org/10.1001/archsurg.2010.132
ER  -