[Necrosectomy and bursa lavage in necrotizing pancreatitis. Results of a prospective clinical study].
In a prospectively performed clinical trial a surgical management protocol including necrosectomy and postoperative local lavage of the necrosis cavity and the omental bursa was applied in 95 patients with necrotizing pancreatitis. In 80% of them severe organ failures occurred preoperatively, in spite of intensive care treatment. The median value of early prognostic signs of these patients was 4.5. Intraoperatively 59% showed extended pancreatic necroses and 66% an extension of the necroses into extrapancreatic tissue structures; in 42% bacteria were detected in the necrotic material. After necrosectomy the postoperative local lavage was performed for an average period of 25 days with 8 1 of lavage fluid per 24 hours in median. The average intensive care period came to 7.0 days, the average postoperative hospital time was 60 days. The hospital mortality amounted to 8.4%. The advantage of this management protocol including necrosectomy and postoperative local lavage lies in the continuous emptying of vasoactive and toxic substances, germs and necrotic material.
Beger
H G
HG
Abteilung für Allgemeine Chirurgie, Universität Ulm/Donau.
Büchler
M
M
Block
S
S
Bittner
R
R
Roscher
R
R
Oettinger
W
W
D000208:Acute Disease; D003131:Combined Modality Therapy; D006801:Humans; D009336:Necrosis; D010179:Pancreas / Q000473:pathology; D010186:Pancreatic Function Tests; D010195:Pancreatitis / Q000473:pathology / Q000601:surgery*; D010533:Peritoneal Lavage / Q000379:methods*; D011183:Postoperative Complications / Q000473:pathology; D011446:Prospective Studies
Nekrosektomie und Bursa-Lavage bei nekrotisierender Pankreatitis. Ergebnis einer prospektiven klinischen Studie.