[Acute necrotizing hemorrhagic pancreatitis. Surgical treatment (author's transl)]

From 1976 till 1980, 30 patients were operated upon for acute necrotizing hemorrhagic pancreatitis (ANHP). All patients had severe signs of necrosis. Thirty-three operations were performed on these patients: 7 total pancreatectomies, 3 sub-total pancreatectomies, 1 Whipple procedure, 6 left pancreatectomies and 2 caudal-pancreatectomies. Furthermore, 9 patients had an extended sequestrectomy with drainage-lavage, 2 pseudo-cysts were drained into the pancreas and an extended sequestrectomy was performed through the opening in the posterior wall of the stomach; 3 more patients had a simple drainage-lavage of the pancreatic area performed. Twelve patients, among whom 11 with diffuse total ANHP, died after the procedure. The operative indications are discussed together with the possible advantage of using the CT-scan. The therapeutic approach of the biliary ANHP is demonstrated.