[Acute pancreatitis--the need for an active approach. Experience in our department]

The authors draw attention to the rising incidence of acute pancreatitis, based on their own observations. They present very briefly the last version of the classification of acute pancreatitis, the so-called Atlanta classification of 1992. They summarise methods of conservative treatment of acute pancreatitis which they used as a basis for elaborating their own therapeutic pattern. In the presented group in 1995 19 patients with the diagnosis of acute pancreatitis were treated which was diagnosed based on the clinical condition, biochemical results, US and CT examination of the pancreas. CT examination is considered most important. In three instances acute non-complicated pancreatitis was involved, seven times acute accumulation of fluid in the pancreas and eight times acute necrosis of the pancreas. In 13 men and 6 women the mean age was 54.3 years. As to the aetiology, acute pancreatitis was 9 times of biliary origin, 6 times due to alcohol abuse, twice due to ERCP, once after chemotherapy and in one case the cause was not revealed. All patients with acute necrosis of the pancreas were operate by laparostomy, zip closure was used and repeated surgical revisions were made. Of 19 patients 8 died (all with acute necrosis of the pancreas). In antibiotic prevention of secondary infection of the pancreas in acute pancreatitis cefazoline proved most useful. Aprotinine administration to inhibit proteases is according to the authors effective only during the first 48 hours after the onset of the disease.