[Total pancreatectomy in acute necrotizing hemorrhagic pancreatitis. Indications and technic]

The place of total pancreatectomy in the treatment of pancreatitis is still ill- defined. The author makes a plea for this operation and notes the indications, the surgical technique and its results and possible complications. The operation is indicated in cases of total or 2/3 rds necrosis of the gland, in cases involving the head of the pancreas and part of the body. The gland should be dissected out and continuity should be restored by choledoco-jejunal and gastro-jejunal anastomoses. The important thing is to carry out this operation early, between the 3rd and 6th day, treating the areas of necrosis before the lesions become the site of uncontrolled infection. 7 patients out of 9 operated on in this way, are alive with easily controlled diabetes, a low fat diet and pancreatic extract.