Staging Laparoscopy with Laparoscopic Ultrasonography ...

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Chronic PancreatitisNon-operative Management• Mandatory abstinencefrom alcohol• Exogenous pancreaticenzyme supplements• Insulin and dietmodification• Pain medications• Endoscopic approaches• Percutaneous nerveablations• Psychosocialrehabilitation‣ DIAGNOSTIC WORKUP– Ultrasound– CT Scan– ERCP / MRCP– Exocrine / EndocrineFunctionUltimately, 60-65% ofChronic PancreatitisPatients will need Surgery
Indications for SurgicalTreatmentChronic Pancreatitis• Medically intractable abdominal pain• Local Anatomic complications• Main Pancreatic duct Stenosis <strong>with</strong>dilatation in body and tail• Suspected, but unproven, malignancy
Page 1:
PancreatitisCharles M. Vollmer, Jr.
Page 4 and 5:
Pancreatitis
Page 6 and 7:
Classification of PancreatitisAcute
Page 8 and 9:
Mechanisms ofAcute Pancreatitis•
Page 10 and 11:
Etiology• Alcohol• Gallstones
Page 12 and 13: What Now?What is the differential?W
Page 15 and 16: Clinical FeaturesSigns and Symptoms
Page 17 and 18: Mortality and Ranson’s CriteriaRa
Page 19 and 20: Change in Plans8 hours later….The
Page 21 and 22: Basic TenentsFluidsEnd organ suppor
Page 23 and 24: What’s the diagnosis?
Page 25 and 26: Indications for BiliarySphincteroto
Page 27 and 28: Why is he still febrile?
Page 29 and 30: HD # 15• WBC 25,000 and rising•
Page 31 and 32: Infection• Pneumonia• Line Seps
Page 33 and 34: Pancreatic NecrosisDiffuse or focal
Page 35 and 36: Sterile Necrosis:Operative Indicati
Page 37: Clinical Signs of InfectedNecrosis
Page 44 and 45: Abscess
Page 46 and 47: Rational of SurgicalManagementRemov
Page 50 and 51: HD # 25Why is he still in the ICU?
Page 52 and 53: MSOF• Pulmonary• Renal• Cardi
Page 54: Pancreatic Pseudocyst
Page 57 and 58: Chronic Pancreatitis
Page 59 and 60: Course of Chronic Pancreatitis10080
Page 61: Pathophysiology of Chronic Pancreat
Page 65: ERCP
Page 69 and 70: Chronic PancreatitisSurgical Manage
Page 71: Chronic PancreatitisDuctal Drainage
Page 77: Long-Term Outcome after Duct Draina
Page 80 and 81: Traditional Pancreatic HeadResectio
Page 83: Afferent Limb ReconstructionCommonH
Page 86 and 87: DPPHR
Page 88 and 89: Distal Pancreatic ResectionsNOT rec
Page 90: PancreatitisCharles M. Vollmer, Jr.
Page 93: Etiology of Acute Pancreatitis• P
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Staging Laparoscopy with Laparoscopic Ultrasonography ...

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