title: [Operative treatment of acute pancreatitis].
abstract: Most attacks of acute pancreatitis are self limiting, and the patients recover completely within days or weeks. In a few cases, however, the course is severe, with development of organ failure (single or multiple) and local complications such as necrosis, abscesses, and pseudocist. Between 01.01.2001-01.06.2004, 286 cases of acute pancreatitis were treated in our clinic. The purpose of this study is to represent indication for operative treatment of acute pancreatitis and its complications, according to the Atlanta classification. According to our date, the most frequent cause are changes on biliary tract. Of these 286 patients, 247 suffered from a mild or moderate type of acute pancreatitis and responded fully to medical treatment (215 patients) or to biliary tract surgery (32 patients). The hospital mortality of this group of patients was 2.4%. Surgery was indicated when the patients developed signs of an acute abdomen (9 patients), pancreatic pseudocyst (7 patients), progressiv icterus (2 patients), infection of pancreatic necrosis (10 patients), and pancreatic abscess (7 patients). Four patients with pancreatic necrosis were stable, and they had conservative treatment. The most difficult decision in the management of these patients is whether surgery is required and which of the complementary approaches to necrosectomy and drainage is appropriate. The hospital mortality of patients with severe acute pancreatitis was 28.2%. Multiple organ failure was the predominant cause of death.
authors.affiliation: Klinika za Hirurgiiu, Univerzitetski Klini1ki Centar Tuzla.
authors.forename: Deso
authors.initials: D
authors.lastname: Mesić
authors.forename: Sefik
authors.initials: S
authors.lastname: Hasukić
authors.forename: Mirsada
authors.initials: M
authors.lastname: Praso
authors.forename: Amer
authors.initials: A
authors.lastname: Odobasić
authors.forename: Nedzad
authors.initials: N
authors.lastname: Kadrić
authors.forename: Zijah
authors.initials: Z
authors.lastname: Rifatbegović
authors.forename: Fuad
authors.initials: F
authors.lastname: Pasić
authors.forename: Mirha
authors.initials: M
authors.lastname: Agić
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D018579:Patient Selection