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Postoperative lavage and on demand surgical intervention in the treatment of acute necrotizing pancreatitis

Jan De Waele (UGent) , Uwe Hesse (UGent) , Piet Pattyn (UGent) , Johan Decruyenaere (UGent) and Bernard de Hemptinne (UGent)
(2000) ACTA CHIRURGICA BELGICA. 100(1). p.16-20
Author
Organization
Abstract
Objective: to analyse our experience with a combined approach of postoperative local lavage and on demand surgical intervention in the treatment of acute necrotizing pancreatitis. Patients and methods: all patients operated on for acute pancreatitis in a tertiary hospital between June 1993 and July 1997 were studied retrospectively. Demographic data, Ranson score, APACHE II score at admission were recorded. Hospital charts and clinical courses were reviewed, Results: Seventeen patients were treated surgically because of end stage multiple organ failure (MOF) (n = 13) or infected necrosis (n = 4). APACHE II and Ranson scores were 26,2 +/- 9,25 and 7,33 +/- 1,35 respectively. All patients had protracted clinical courses, and required aggressive intensive care therapy. Forty-eight surgical interventions were performed in 17 patients. Early mortality was 36 percent. Complications were numerous, and mostly consisted of intra-abdominal abscesses. Young age (under 55) was associated with significantly better outcome (22% vs. 87% mortality, p = 0,015) Conclusion: Continuous local lavage after surgical debridement, with on demand re-laparotomy, proves to be a valuable approach in patients with necrotizing pancreatitis with acceptable morbidity and mortality rates. It appears however, that the role of surgery for acute pancreatitis is limited to patients with infected necrosis or end stage MOF.
Keywords
pancreatitis-complications, acute-disease, pancreatitis-mortality, pancreatitis-pathology, pancreatitis-surgery, COMPUTED-TOMOGRAPHY, NECROSIS, NECROSECTOMY

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Chicago
De Waele, Jan, Uwe Hesse, Piet Pattyn, Johan Decruyenaere, and Bernard de Hemptinne. 2000. “Postoperative Lavage and on Demand Surgical Intervention in the Treatment of Acute Necrotizing Pancreatitis.” Acta Chirurgica Belgica 100 (1): 16–20.
APA
De Waele, Jan, Hesse, U., Pattyn, P., Decruyenaere, J., & de Hemptinne, B. (2000). Postoperative lavage and on demand surgical intervention in the treatment of acute necrotizing pancreatitis. ACTA CHIRURGICA BELGICA, 100(1), 16–20.
Vancouver
1.
De Waele J, Hesse U, Pattyn P, Decruyenaere J, de Hemptinne B. Postoperative lavage and on demand surgical intervention in the treatment of acute necrotizing pancreatitis. ACTA CHIRURGICA BELGICA. 2000;100(1):16–20.
MLA
De Waele, Jan, Uwe Hesse, Piet Pattyn, et al. “Postoperative Lavage and on Demand Surgical Intervention in the Treatment of Acute Necrotizing Pancreatitis.” ACTA CHIRURGICA BELGICA 100.1 (2000): 16–20. Print.
@article{126279,
  abstract     = {Objective: to analyse our experience with a combined approach of postoperative local lavage and on demand surgical intervention in the treatment of acute necrotizing pancreatitis.
Patients and methods: all patients operated on for acute pancreatitis in a tertiary hospital between June 1993 and July 1997 were studied retrospectively. Demographic data, Ranson score, APACHE II score at admission were recorded. Hospital charts and clinical courses were reviewed,
Results: Seventeen patients were treated surgically because of end stage multiple organ failure (MOF) (n = 13) or infected necrosis (n = 4). APACHE II and Ranson scores were 26,2 +/- 9,25 and 7,33 +/- 1,35 respectively. All patients had protracted clinical courses, and required aggressive intensive care therapy. Forty-eight surgical interventions were performed in 17 patients. Early mortality was 36 percent. Complications were numerous, and mostly consisted of intra-abdominal abscesses. Young age (under 55) was associated with significantly better outcome (22\% vs. 87\% mortality, p = 0,015)
Conclusion: Continuous local lavage after surgical debridement, with on demand re-laparotomy, proves to be a valuable approach in patients with necrotizing pancreatitis with acceptable morbidity and mortality rates. It appears however, that the role of surgery for acute pancreatitis is limited to patients with infected necrosis or end stage MOF.},
  author       = {De Waele, Jan and Hesse, Uwe and Pattyn, Piet and Decruyenaere, Johan and de Hemptinne, Bernard},
  issn         = {0001-5458},
  journal      = {ACTA CHIRURGICA BELGICA},
  keyword      = {pancreatitis-complications,acute-disease,pancreatitis-mortality,pancreatitis-pathology,pancreatitis-surgery,COMPUTED-TOMOGRAPHY,NECROSIS,NECROSECTOMY},
  language     = {eng},
  number       = {1},
  pages        = {16--20},
  title        = {Postoperative lavage and on demand surgical intervention in the treatment of acute necrotizing pancreatitis},
  volume       = {100},
  year         = {2000},
}

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