dc.contributor.author |
Windsor, John |
en |
dc.contributor.author |
Escott, A |
en |
dc.contributor.author |
Brown, L |
en |
dc.contributor.author |
Phillips, Anthony |
en |
dc.date.accessioned |
2018-10-10T20:21:19Z |
en |
dc.date.issued |
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 |
http://hdl.handle.net/2292/40486 |
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 http://dx.doi.org/10.1111/jgh.13784. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. |
en |
dc.rights.uri |
https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm |
en |
dc.rights.uri |
https://authorservices.wiley.com/author-resources/Journal-Authors/licensing/self-archiving.html |
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 |
http://purl.org/eprint/accessRights/OpenAccess |
en |
pubs.subtype |
Article |
en |
pubs.elements-id |
617383 |
en |
pubs.org-id |
Medical and Health Sciences |
en |
pubs.org-id |
School of Medicine |
en |
pubs.org-id |
Surgery Department |
en |
pubs.org-id |
Science |
en |
pubs.org-id |
Biological Sciences |
en |
pubs.org-id |
Science Research |
en |
pubs.org-id |
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 |