[Repeated laparotomy for acute necrotizing pancreatitis]

In the period of 1984-1996, 569 patients were treated for acute pancreatitis and 37 of them (6.5%) developed infected pancreatic necrosis (IPN). All these patients were submitted to repeated laparotomies according to Bradley's procedure. The IPN was caused by: bile duct stones--in 11 cases, alcohol abuse-14, ERCP-6, trauma-1, in 6 cases the etiology was cryptogenic. The accuracy of imaging tests was: USG-62%, CT-100%. Sepsis was present in all cases, and multiorgan insufficiency-in 25 patients. Hospital mortality was 30% (11 patients). The most frequent reason of death was multiorgan insufficiency. The actuarial survival was 26 patients (70%).