Conservative surgical treatment for acute pancreatitis: the Lawson procedure

Twenty-seven patients with acute necrotizing pancreatitis were treated with the Lawson procedure, consisting of closed drainage of the lesser sac, cholecystostomy, gastrostomy and jejunostomy. Retrospectively, the effect of the treatment was judged in relation to mortality and morbidity. Thirteen patients (48%) died, all of them due to sepsis and multiple organ failure. This considerable mortality was undoubtedly also influenced by the serious condition of most patients as reflected by the number of positive Ranson criteria. Seven patients (26%) had to be reoperated on because of abscesses. The high incidence of abscesses and the sepsis in all deceased patients indicate an insufficient drainage of the lesser sac with this method. Of the three stomas only jejunostomy proved to be useful for quick resumption of enteral feeding.