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Changing strategies in the surgical management of acute necrotizing pancreatitis
H Paajanen1, M Jaakkola, J Karjalainen
1Department of Surgery, Tampere University Hospital, Finland.
International Surgery
|January 1, 1994
Abstract:
During 1982-90 we changed the surgical treatment of acute necrotizing pancreatitis twice. The operative strategy consisted of early formal resection (n = 13) during 1982-84, early lavational surgery (n = 15) during 1985-87 and late necrosectomy (n = 17) during 1988-90. The mortality rate decreased from 54% to 40% and to 24%, respectively. The pattern of complications changed from bleeding in resections to pseudocysts and fistulas in late necrosectomy. Sepsis and multiorgan failure were still main problems. These results led us to begin a prospective study of planned repeated debridement by open packing after delayed necrosectomy.