[Surgical treatment of acute and chronic pancreatitis]

The acute haemorrhagically necrotizing pancreatitis demands, as a rule, an operative sanation of the local complications. The partial or total pancreatectomy during the first days for preventing the late local complications is loaded with an operation mortality from 35 to 60%. If the early operation is limited to the removal of recognizable and demarkated necroses, the mortality decreases to 30 or 35%. In principal preference of a retarded date of operation and in consequent sanation of local changes, if necessary in repeated interventions, the mortality is between 20 and 33%. The surgical treatment of the chronic pancreatitis shall concerning indication to operation, tactics and kind of intervention always take into consideration an existing abuse of alcohol. Long-term controls revealed that the most essential life-limiting factor is a further existing alcoholism. The more parenchyma is removed in operation the higher is the late mortality.