Advances in surgery
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Gallstones are the most common cause of acute pancreatitis in the western world. Most patients with ABP suffer a mild attack and are expected to make a full recovery. They can be managed supportively and undergo laparoscopic cholecystectomy with IOC during their initial hospitalization to prevent recurrence. ⋯ A prompt diagnosis requires a high degree of suspicion and clinical acumen. Recognizing patients with severe pancreatitis is an important priority because it affects the type and timing of intervention. The management of these patients requires close clinical observation and a multidisciplinary approach between the surgeon, radiologist, gastroenterologist, and intensivist.
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Advances in surgery · Jan 2006
ReviewThe importance of insulin administration in the critical care unit.
In the last decade investigation into the importance of glucose control and insulin administration in a wide variety of clinical settings has occurred. In virtually all studies, whether of cardiac ischemia or bypass surgery, cerebrovascular recovery from ischemia or head injury, or surgical critical illness, intensive insulin therapy with tight glucose control has resulted in improved clinical outcomes by decreasing both morbidity and mortality. The fundamental biochemical mechanisms for these findings are increasingly well understood and explain the apparent far-reaching beneficial effects of this therapy. In the future, it is likely that all hospitalized surgical patients will have tight glucose control.