[Indication of delayed surgery in the postacute phase of hemorrhagic necrotizing pancreatitis]

In acute hemorrhagic-necrotizing pancreatitis partial necrosis with good response to conservative therapy can be differentiated from extensive necrosis with no response to conservative therapy. In case of surviving the acute phase sequester and abscess are often to be seen in the "postacute phase", after 10-14 days. The indications for the "delayed operation" in this postacute phase are development of a palpable mass together with clinical deterioration and other complications. The surgical procedure consists of digital removal of necrotic tissue (sequestrotomy), abscess incision and resection. Since 1971 84 of 93 patients with a postacute pancreatitis were operated, two third survived.