[Surgical therapy of acute pancreatitis]

Treatment was applied to 181 patients for acute pancreatitis at the Surgical Department of Friedrichshain Local Hospital, between December 1, 1985 and October 30, 1987. Ninety-two of these patients were in Stage I according to Kümmerle-Hollender, 62 in Stage II, and 27 in Stage III. Operations were performed on 57 patients, among them three in Stage I, 27 in Stage II, and another 27 in Stage III. Peritoneal lavage was the initial approach taken to patients in whom ascites had been positively established. Decision-making on surgical therapy depended on the further clinical course as well as on CT and sonographic determination of organ-specific alterations, with surgery being considered most optional for Stage III. Efforts then would be made to remove all necrotic material, with the transverse laparotomy wound logically remaining unclosed. The peritoneal cavity can thus be revised once in two or three days. These therapeutic results, primarily in Stage III, are considered by the authors as a good success of insistence on early radical therapeutic surgery without closure of the laparotomy wound, that is peritoneostoma with stagewise lavage.