Severe Acute Pancreatitis - Determinant Factors and Current Therapeutic Conduct

Considered by Dieulafoy as the "great abdominal drama", acute pancreatitis has always been, and still remains, a real diagnostic and therapeutic challenge because of its etiological, clinical and biological variability, the unpredictable evolution and the difficulty of establishing appropriate treatment for each patient. In this context, various, sometimes diametrically opposed, conceptions about the interpretation of the cases and the adopted therapeutic algorithm have been encountered over time, as evidenced by the great number of papers dedicated to this subject. A more thorough understanding of acute pancreatitis pathophysiology, with increasing interest in severity classification based on determinant factors (local and general) are decisive factors in predicting severity and adopting the modern therapeutic strategy of this complex and heterogeneous disease.

Keywords: severe acute pancreatitis, determinant factors, multiple organ dysfunction (MODS), walled of necrosis (WON ), necrosectomy, hybrid surgical techniques

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