[Experiences in management of acute necrotic pancreatitis]

To establish a treatment program for patients with acute necrotic pancreatits (ANP), we treated 211 patients with ANP from 1973 to 1995. 122 patients in group A were treated mainly by early operation before 1992 and 75 in group B, by early nonoperativemethod. The results showed that the occurrance of complications (ARDS, renal failure, heart failure, pancreatic abscess, intestinal fistula) was lower than that in the group B (P < 0.01). Also the mortality in the group B (10.67%) was decreased as compared with that (22.95%) in the group A. We suggested that the nonoperative treatment with rigid criterion for ANP might be recommended first. An intensive nonsurgical management of ANP, surgical indications during nonoperative period and complete program of management for ANP were discussed.