[Surgical indications in acute pancreatitis]

The indication for surgery in acute hemorrhagic necrotizing pancreatitis (AHNP) depends on the severity of the disease and the clinical course. Both factors must be determined daily, based on clinical and laboratory data. CAT-scan does not contribute much to indication. An early operation is necessary if despite an optimal intensive care septic symptoms and signs persist and renal and respiratory failure occur. Surgery is indicated 2-3 weeks after onset of AHNP if septic complications (re)-occur. A close follow up is mandatory.