In situ high-volume modified continuous closed and/or open lavage for infected necrotizing pancreatitis.
OBJECTIVE
To evaluate the clinical significance of high-volume modified continuous closed and/or open lavage for the treatment of infected necrotizing pancreatitis.


METHODS
From August 1997 to December 2006, 53 patients with infected necrotizing pancreatitis who underwent in situ high-volume (>20 L/d) continuous closed lavage using a single-lumen rubber catheter and/or open lavage were retrospectively studied in our hospital, and the advantages of this new technique were analyzed.


RESULTS
Modified continuous closed lavage was the initial treatment for all patients; in 6 patients with secondary retroperitoneal sepsis or abscess, continuous open lavage was performed. Impaired tube patency and lavage fluid retention did not occur in any of these patients. The overall mortality was 17.0% (9/53). Twelve patients underwent early surgery, and 5 (41.7%) died; 41 patients underwent delayed surgery, and 4 (9.8%) died. Significant local complications occurred in 14 patients (26.4%); the incidence of bleeding, abscess, and fistula was 13.2% (7/53), 9.4% (5/53), and 9.4% (5/53), respectively.


CONCLUSIONS
Our technique of in situ high-volume modified continuous closed and/or open lavage has produced a better control of infected necrotizing pancreatitis.
Dong
Xin
X
Department of Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, PR China.
Gao
Shun Liang
SL
Xie
Qiu Ping
QP
Xu
Lin
L
Xu
Yuan Liang
YL
Wu
Yu Lian
YL
D044963:Biopsy, Fine-Needle; D003646:Debridement; D005260:Female; D006801:Humans; D007239:Infections / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D008297:Male; D019283:Pancreatitis, Acute Necrotizing / Q000150:complications* / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D007507:Therapeutic Irrigation / Q000295:instrumentation / Q000379:methods*