[Modern strategies in surgical treatment of acute necrotic pancreatitis]

The experience of surgical treatment of acute necrotic pancreatitis (ANP) in 172 patients in 1997-2002 were summarized. We started therapy from conservative treatment. In 43 (25%) patients with ANP video laparoscopic intervention in enzyme-toxic period were performed. In 32 of them we avoided laparotomy. Percutaneous intervention under the control of ultrasound imaging was conducted in 130 (75.6%) patients. This procedure was final in 81 patients, 58 (33.7%)--underwent laparotomy, in 42 of them concerning ANP. Postoperative mortality was 11.1%. Individual approach, strict following the tactics chosen, wide use of miniinvasive techniques in deferred period when necessary, laparotomy ensures significant progress in the treatment of ANP.