Indicativo cirúrgico em pacientes com pancreatite aguda necrosante: uma revisão integrativa.

Abstract

Introdution: Acute Pancreatitis is defined as na acute inflammatory disease of the pâncreas. In its severe form it can progress to pancreatic necrosis and peripancreatic tissue, and even infection of necrosis, whith may require surgical intervention. From this perspective, the moment for surgery indication is a key point for the prognosis of these patients. Objective: identify the ideal surgical technique for the treatment of patients with necrotizing pancreatitis and the right time for the indication of surgery in these patients. Method: the presente work is an integrative literature review. The search for articles were conducted on the databases such as PubMed and SciELO, using the descriptors: Pancreatitis. Acute Pancreatitis Necrotizing. Surgical procedures operative. Over 5900 references were identified, of which after the use of the criteria such as inclusion, articles published in Portuguese and English, with the descripitors. Pacreatitis. Pancreatites acute necrotizing. Surgical procedures operative. As well as the realization of readin and careful analysis, totaled 6 articles. Results: based on the contente presented in the article, it was possible to evaluate the main types of research conducted in the country and internationally. The studies showed the importance of the topic, since the absence of a protocol unique service related to clinical conditions generates damages to patients, such as increased morbidity and mortality, complications and increased spending on health. Conclusion: the delay for the surgical procedure showed lower incidence of complications in patients who waited at least four weeks onset of symptoms to surgery. There is no consensus among authors about when the surgery should be indicated, but some clinical situations have less disagreement as infected pancreatic necrosis, hemorrhage, intestinal perforation, symptomatic bounded pancreatic necrosis and sterile necrosis with progressive clinical deterioration, despite optimal therapheutic support. The necrosectomy allows the removal of focus and improvement of clinical conditions of patients, enabling a reduction in morbidity and mortality.