A systematic review on the alternative diagnostic and treatment options for pancreatitis

Acute pancreatitis is often associated with various complications like pancreatic necrosis, pseudocysts and ductal disruptions, which need surgical interventions. The conventional method of surgery, i.e. open necrosectomy causes significant morbidity, post-operative complications, and has high mortality rate. To overcome this problem, alternative minimally invasive options are needed. The alternative minimally invasive surgical procedures include laparoscopy, endoscopy, percuataneous image guided drainage and debridement surgeries, via transperitoneal, retroperitoneal and percutaneous route. The diagnostic techniques used in pancreatitis are also not up to the mark. The exact location of pancreatic disruption, its mass and composition cannot be provided by convention techniques like CT scan, ultrasound and MRI. The new advanced techniques for exact diagnosis of pancreatic complications, tissue blood perfusion, ductal morphology of pancreatitis are needed for proper prognosis of pancreatitis. MR cholangiopancreatography, endoscopic ultrasound, acoustic radiation force elastography, ASL perfusion imaging are some of the advanced techniques used in the diagnosis of pancreatitis and its complication. In this review, various minimally invasive surgeries and advanced diagnosis techniques have been listed and evaluated in comparison to conventional surgical and diagnostic methods. The evaluation has done on the basis efficacy and safety. On the basis of available literature, it was concluded that though the minimally invasive surgeries are much safer than conventional surgical procedures yet their efficacy is still controversial.