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Article
April 1986

Surgical Management of Necrotizing Pancreatitis

Author Affiliations

From the Department of Surgery, University of Massachusetts Medical School, Worcester.

Arch Surg. 1986;121(4):484-487. doi:10.1001/archsurg.1986.01400040122020
Abstract

• Necrotizing pancreatitis has a formidable mortality that may exceed 55% even when treated by surgical drainage. Standard surgical techniques for controlling pancreatic sepsis are often inadequate because the unique chronicity of pancreatitis results in persistent and ongoing inflammation and sloughing of necrotic retroperitoneal tissue that promotes further sepsis. Ten consecutive high-risk patients in whom standard surgical débridement and drainage had failed were treated with open packing of the pancreatic bed. This was followed by daily débridement dressing changes at the bed-side in the surgical intensive care unit. Management of the open abdomen in the surgical intensive care unit using standard surgical techniques ensured optimum wound toilet, prevented recurrent intra-abdominal sepsis, was logistically acceptable, was well tolerated by critically ill patients, and allowed a higher salvage rate (80%) of high-risk patients than might otherwise be anticipated.

(Arch Surg 1986;121:484-487)

References
1.
Fitz RH:  Acute pancreatitis: A consideration of pancreatic hemorrhage, hemorrhagic, suppurative, and gangrenous pancreatitis, and of disseminated fat-necrosis . Med Record 1889;35:197-204.
2.
Altemeier WA, Alexander JW:  Pancreatic abscess: A study of 32 cases . Arch Surg 1963;87:89-89.Article
3.
Ranson JHC, Rifkind KM, Turner JW:  Prognostic signs and non-operative peritoneal lavage in acute pancreatitis . Surg Gynecol Obstet 1976;143:209-219.
4.
Ranson JHC, Spencer FC:  Prevention, diagnosis, and treatment of pancreatic abscess . Surgery 1977;82:99-106.
5.
Becker JM, Pemberton JH, DiMagno EP, et al:  Prognostic factors in pancreatic abscess . Surgery 1984;96:455-461.
6.
Warshaw AL, Jin G:  Improved survival in 45 patients with pancreatic abscess . Ann Surg 1985;202:408-417.Article
7.
Bradley EL, Fulenwider T:  Open treatment of pancreatic abscess . Surgery 1984;159:509-513.
8.
Davidson ED, Bradley EL:  'Marsupialization' in the treatment of pancreatic abscess . Surgery 1981;89:252-256.
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