[Advantages and disadvantages of planned staged relaparotomy using the zipper technique in surgical treatment of necrotizing pancreatitis].
The rationale of surgical intervention during acute necrotizing pancreatitis is to remove necrotic tissue preserving healthy glandular parenchyma and other adjacent structures, thus limiting severe complications. Necrosectomy and debridement are the crucial in surgical management, further treatment of pancreatic bed and peripancreatic tissue are still a matter of debate among pancreatic surgeons. Zipper technique is one of the three recognized methods [table: see text] for the surgical management of necrotizing pancreatitis. The aim this study was to review the literature data about treatment using this technique, as well to compare the results of treatment with other techniques, in order to present the advantage and disadvantage of zipper technique. The main advantage of this technique is a high level of control of intraabdominal infection and other septic complications associated with necrotizing pancreatitis and its surgical management. Increased risk of development of gastrointestinal and pancreatic fistulas as well of intraabdominal bleeding is probably the main disadvantage. A flexible approach focused on the individual patients is a reasonable solution in the surgical management of the necrotizing pancreatitis.
Centar za Urgentnu hirurgiju, Urgentni Centar, KCS, Beograd.
D
D
Radenković
Dj
Dj
Bajec
A
A
Karamarković
B
B
Stefanović
P
P
Gregorić
M
M
Milićević
D006801:Humans; D007813:Laparotomy / Q000009:adverse effects / Q000379:methods*; D019283:Pancreatitis, Acute Necrotizing / Q000601:surgery*; D011183:Postoperative Complications; D012086:Reoperation