Treatment of acute pancreatitis

BACKGROUND: The role of surgery in the treatment of acute pancreatitis is still unclear. The aim of this study was to evaluate and compare our results with different treatment strategies described in the literature. MATERIAL AND METHODS: From 1980 to 1998, 376 patients, 195 women and 181 men, median age of 62.5 years (15-96 years) with acute pancreatitis were treated in our hospital. The classification of the pancreatitis was based on Ranson signs (more than four defined as serious). Patients with septic necrosis/abscesses were treated with percutaneous drainage and irrigation. RESULTS: The disease was caused by gallstone in 58%, ethyl in 13%, unknown cause in 14%, and miscellaneous in 15%. In 50 patients (13%) the pancreatitis was serious. Ten patients (2.6%) died in hospital. Among all patients with serious/haemorrhagic pancreatitis the mortality was 18%. INTERPRETATION: Intensive supportive care and broad spectrum antibiotics combined with percutaneous drainage and irrigation of infected intraabdominal content in haemorrhagic pancreatitis seem to give the same results as open surgery.