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World J Gastrointest Surg. Sep 27, 2023; 15(9): 1879-1891
Published online Sep 27, 2023. doi: 10.4240/wjgs.v15.i9.1879
Surgical decompression for the management of abdominal compartment syndrome with severe acute pancreatitis: A narrative review
Prashant Nasa, Gunjan Chanchalani, Deven Juneja, Manu LNG Malbrain
Prashant Nasa, Department of Critical Care Medicine, NMC Specialty Hospital, Dubai 7832, United Arab Emirates
Prashant Nasa, Department of Internal Medicine, College of Medicine and Health Sciences, Al Ain 15551, United Arab Emirates
Gunjan Chanchalani, Department of Critical Care Medicine, K.J. Somaiya Hospital and Research Centre, Mumbai 400022, India
Deven Juneja, Institute of Critical Care Medicine, Max Super Specialty Hospital, New Delhi 110017, India
Manu LNG Malbrain, First Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, Lublin 20-954, Poland
Manu LNG Malbrain, Executive Administration, International Fluid Academy, Lovenjoel 3360, Belgium
Manu LNG Malbrain, Medical Data Management, Medaman, Geel 2440, Belgium
Author contributions: Nasa P conceptualized and designed the article; Nasa P and Chanchalani G performed acquisition of data, analysis and interpretation of data, and drafted the article; Juneja D and Malbrain ML revised the article; and all authors have read and approved the final manuscript.
Conflict-of-interest statement: Nasa P declared to be on the advisory board of Edwards life sciences. Malbrain ML is Professor of Critical Care Research at the 1st Department of Anesthesiology and Intensive Therapy, Medical University of Lublin, Poland. He is co-founder, past-President and current Treasurer of WSACS (The Abdominal Compartment Society, http://www.wsacs.org). He is member of the medical advisory Board of Pulsion Medical Systems (now fully part of Getinge group), Serenno Medical, Potrero Medical, Sentinel Medical and Baxter. He consults for B. Braun, Becton Dickinson, ConvaTec, Spiegelberg, Medtronic, MedCaptain, and Holtech Medical, and received speaker’s fees from PeerVoice. He holds stock options for Serenno and Potrero. He is co-founder and President of the International Fluid Academy (IFA). The IFA (http://www.fluidacademy.org) is integrated within the not-for-profit charitable organization iMERiT, International Medical Education and Research Initiative, under Belgian law. Other authors do not declare any conflict of interest in relation to the content of the present paper.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Prashant Nasa, MD, Chief Physician, Department of Critical Care Medicine, NMC Specialty Hospital, Al Nahda 2, Amman Street, Dubai 7832, United Arab Emirates. dr.prashantnasa@gmail.com
Received: May 23, 2023
Peer-review started: May 23, 2023
First decision: July 8, 2023
Revised: July 20, 2023
Accepted: August 1, 2023
Article in press: August 1, 2023
Published online: September 27, 2023
Processing time: 121 Days and 18.3 Hours
Core Tip

Core Tip: Intra-abdominal hypertension (IAH) plays a pivotal role in the pathophysiology of new-onset organ failure in patients with severe acute pancreatitis (SAP). Abdominal compartment syndrome (ACS), a sustained elevation of Intra-abdominal pressure of more than 20 mmHg associated with one or more new organ dysfunction, reflects an unabated progression of IAH. Surgical decompression is an effective core strategic component to manage an overt ACS. However, the morbidity of an open abdomen after decompressive laparotomy should be weighed against the potentially lethal and inadequately treated ACS. Prospective randomized studies are required to evaluate the appropriate timing, technique, and triggers for surgical decompression in ACS associated with SAP.