[Treatment of intra-abdominal sepsis and necrotizing pancreatitis with staged lavage using a Zipper].
The mortality of generalised intra-abdominal sepsis and severe necrotising pancreatitis remains very high. The persistence of intra-abdominal septic foci leads to recurrent abscess formation, persistence of sepsis and development of multiple organ failure, ultimately leading to the death of the patient. Therefore we believe that a repeated and total elimination of all septic and necrotic material is the cornerstone of an adequate surgical therapy in these patients. We performed "staged lavage" with the aid of a Zipper in 24 patients (10 with intra-abdominal sepsis and 14 with severe necrotising pancreatitis). Via the Zipper 98 relaparotomies were performed (mean 4.1 per patient). The high Apache II-scores (12 to 45, mean 24) illustrate the severity of disease in most of these patients. The expected in-hospital mortality-rate was 59% while in our series 7 patients died on a total of 24 (28%).
Dienst Heelkunde, Universitair Ziekenhuis, Gent.
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F
Vermassen
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D
Meerschaut
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K
Van Landuyt
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P
Pattijn
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F
Derom
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007813:Laparotomy / Q000379:methods / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D010030:Ostomy; D010195:Pancreatitis / Q000473:pathology / Q000628:therapy*; D010538:Peritonitis / Q000209:etiology / Q000628:therapy*; D007507:Therapeutic Irrigation / Q000379:methods*
Behandeling van intra-abdominale sepsis en necrotiserende pancreatitis door middel van etappenlavage met behulp van de Zipper.