INDICATIONS FOR SURGICAL-TREATMENT OF SEV ERE ACUTE NECROTIC PANCREATITIS

Between May 1975 and December 1991, a total of 208 patients were opera ted upon for severe acute necrotic pancreatitis. The decision whether to operate on patients with clinical and biologic aggravation despite particularly sustained intensive care was taken after evaluation of ul trasound and CT scan images. Combining pancreatic body resections and necrotic tissue excision with laparostomy and staged lavage drainage r educed global mortality rate from 49.2 to 16.4 p. cent. The criteria u sed for determining the indication for surgical intervention, and the technical and tactical operative procedures applied allowing this impr ovement, are described and discussed.