[Acute hemorrhagic necrotizing pancreatitis. Analysis of 58 patients]

The authors stress the therapeutic importance of peritoneal lavage for eliminating toxic substances from the abdominal cavity. In cases of a stenosing papilla or an impacted gallstone, endoscopic papillotomy and stone extraction are recommended. The indication for surgical interventions, like nekrosectomy or segmental resection of the pancreas, are discussed in detail. In case of diffuse recurrent peritonitis the technique of the "open abdomen" should be taken into consideration. The results of 44 resections and 14 necrosectomies are represented. The overall mortality rate comes up to 35 or 40% respectively.