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Indocyanine Green-Guided Intraoperative Imaging to Facilitate Video-Assisted Retroperitoneal Debridement for Treating Acute Necrotizing Pancreatitis
04:01

Indocyanine Green-Guided Intraoperative Imaging to Facilitate Video-Assisted Retroperitoneal Debridement for Treating Acute Necrotizing Pancreatitis

Published on: September 8, 2022

The treatment of acute necrotizing pancreatitis, using a mediastinoscope postoperatively and antiseptic rinses

W Wayand, H W Waclawiczek

    The Journal of Hospital Infection
    |March 1, 1985
    PubMed

    Insights

    Acute necrotizing pancreatitis treatment improved significantly. Leaving the abdominal cavity open for surgical access reduced mortality from 70% to 12.5% in severe cases.

    Area of Science:

    • Surgical Innovation
    • Gastroenterology
    • Critical Care Medicine

    Background:

    • Acute necrotizing pancreatitis historically had high mortality rates, exceeding 70% before 1981.
    • Early surgical interventions and antiseptic rinses showed some success, reducing mortality to 50%.

    Purpose of the Study:

    • To evaluate the impact of open abdominal management on mortality in acute necrotizing pancreatitis.
    • To assess the benefits of facilitated surgical access for managing septic complications.

    Main Methods:

    • Comparison of outcomes between patients with conservative abdominal wall closure and those with open management.
    • Inclusion of patients with open abdominal management who underwent packing and had potential for endoscopic debridement.
    • Intra- and postoperative rinsing with povidone-iodine was employed.

    Main Results:

    • Conservative abdominal wall closure in 10 patients resulted in 5 deaths (50% mortality).
    • Open abdominal management in seven patients, with packing and endoscopic access, led to only one death (12.5% mortality).

    Conclusions:

    • Open abdominal management significantly reduces mortality in acute necrotizing pancreatitis.
    • Facilitated surgical access via open management aids in controlling septic complications and improving patient survival.

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