Novel strategies for the treatment of acute pancreatitis based on the determinants of severity: Okuda State-of the-Art Lecture

Show simple item record Windsor, John en Escott, A en Brown, L en Phillips, Anthony en 2018-10-10T20:21:19Z en 2017-11 en
dc.identifier.citation Journal of Gastroenterology and Hepatology 32(11):1796-1803 Nov 2017 en
dc.identifier.issn 0815-9319 en
dc.identifier.uri en
dc.description.abstract Acute pancreatitis (AP) is a common disease for which a specific treatment remains elusive. The key determinants of the outcome from AP are persistent organ failure and infected pancreatic necrosis. The prevention and treatment of these determinants provides a framework for the development of specific treatment strategies. The gut-lymph concept provides a common mechanism for systemic inflammation and organ dysfunction. Acute and critical illness, including AP, is associated with intestinal ischaemia and drastic changes in the composition of gut lymph, which bypasses the liver to drain into the systemic circulation immediately proximal to the major organ systems which fail. The external diversion of gut lymph and the targeting of treatments to counter the toxic elements in gut lymph offers novel approaches to the prevention and treatment of persistent organ failure. Infected pancreatic necrosis is increasingly treated with less invasive techniques, the mainstay of which is drainage, both endoscopic and percutaneous. Further improvements will occur with the strategies to accelerate liquefaction and through a fundamental re-design of drains, both of which will increase drainage efficacy. The determinants of severity and outcome in patients admitted with AP, provide the basis for innovative treatment strategies. The priorities are to translate the gut-lymph concept to clinical practice and to improve the design and active use of drains for infected complications of AP. en
dc.format.medium Print-Electronic en
dc.language eng en
dc.publisher Wiley en
dc.relation.ispartofseries Journal of Gastroenterology and Hepatology en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights This is the peer reviewed version of the following article: Windsor JA, Escott A, Brown L, & Phillips AR (2017). Novel strategies for the treatment of acute pancreatitis based on the determinants of severity. Journal of Gastroenterology and Hepatology, 32(11),1796-1803, which has been published in final form at This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. en
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dc.rights.uri en
dc.title Novel strategies for the treatment of acute pancreatitis based on the determinants of severity: Okuda State-of the-Art Lecture en
dc.type Journal Article en
dc.identifier.doi 10.1111/jgh.13784 en
pubs.issue 11 en
pubs.begin-page 1796 en
pubs.volume 32 en
dc.rights.holder Copyright: Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd en
dc.identifier.pmid 28294403 en
pubs.end-page 1803 en
dc.rights.accessrights en
pubs.subtype Article en
pubs.elements-id 617383 en Medical and Health Sciences en School of Medicine en Surgery Department en Science en Biological Sciences en Science Research en Maurice Wilkins Centre (2010-2014) en
dc.identifier.eissn 1440-1746 en
pubs.record-created-at-source-date 2017-06-26 en
pubs.dimensions-id 28294403 en

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