Talk:Acute pancreatitis
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[edit] Laparoscopy
I changed the text which implied that endoscopy is a treatment. It's a diagnostic procedure. Although useful to help figure out what's going on, endoscopy can actually trigger pancreatitis attacks.
The ERCP (endoscopic retrograde cholangiopancreatography) referred to later in the article is an procedure that utilizes endoscopy, but its not endoscopy. By comparison, although you might use a flashlight to change a lightbulb in a dark closet, you wouldn't say that the flashlight changed the lightbulb.
I replaced endoscopy with laparoscopy.
A specific laparoscopic treatment I know of has been used in the last decade by Dr. Peter Banks (Past President of the American Pancreatic Association, President of the International Association of Pancreatology, Past Chair of the Pancreatic Disorders Section of the American Gastroenterological Association, etc.) at Brigham and Women's Hospital in Boston. It involves making an incision in the sphincter of Oddi so that pancreatic secretions enter the descending duodenum more easily rather than accumulating and causing trouble. -- House of Scandal 14:11, 24 October 2006 (UTC)
- What is the source of your assertion? Some advocate early ERCP to establish whether gallstone disease is the cause of the pancreatitis. The use of sphincterotomy should be supported with citations. Laparoscopy is not useful unless for the specific purpose of draining a pseudocyst. JFW | T@lk 21:29, 6 February 2007 (UTC)
[edit] Reply
I mentioned the sphincterotomy proceedure used by Banks here rather than in the article because I don't have citations regarding it, only personal experience. Statements made in talk pages don't need citations and without citations may be weighed accordingly.
Regarding the statement that "Laparoscopy is not useful unless for the specific purpose of draining a pseudocyst", please note:
Diagnostic laparoscopy is a minimally invasive surgical procedure that allows the visual examination of intra abdominal organs in order to detect pathology. The video image of the liver, stomach, intestines, gallbladder, spleen, peritoneum, and pelvic organs can be viewed on a monitor after insertion of a telescope into the abdomen. Manipulation and biopsy of the viscera is possible through additional ports.[1]
Heres's another description:
Diagnostic laparoscopy is a procedure that allows a health care provider to look directly at the contents of a patient's abdomen or pelvis, including the fallopian tubes, ovaries, uterus, small bowel, large bowel, appendix, liver, and gallbladder. The purpose of this examination is to actually see if a problem exists that has not been found with noninvasive tests. Inflammation of the gallbladder (cholecystitis), appendix (appendicitis), pelvic organs (pelvic inflammatory disease), or tumors of the ovaries may be diagnosed laparoscopically.[2]
Use of a search engine for "Diagnostic Laparoscopy" and similar words will return many thousands of results.
I may have missed your point if your point was that laparoscopy shouldn't be mentioned as a treatment option. My concern was that endoscopy was listed as a treatment option and looking at something isn't treatment. Laparoscopy, on the other hand, may involve cutting, etc.
However, note that there are a number of pancreatitis treatment proceedures besides the draining of a pseudocyst you mentioned and the sphincterotomy I mentioned. The most obvious of these is cholecystectomy. Based on that, the intro seems to still make sense.--House of Scandal 04:26, 14 February 2007 (UTC)
[edit] Tests
PMID 12094843 - a useful review of blood tests. JFW | T@lk 21:29, 6 February 2007 (UTC)
[edit] Antibiotics
"Prophylactic antimicrobials should not be used." is bit of a strong statement. See edits.
