Die akute Pankreatitis : Klassifikation : diagnostik : therapie

Acute pancreatitis is a multietiologic entity with rather diverse clinical courses. Whereas edematous pancreatitis, has a mortality of less than 1%, nowadays; still approximately 20% of all patients with the necrotizing form succumb to the disease. To further improve therapeutic results a standardized approach should be used. For effective treatment the differentiation between edematous and necrotizing pancreatitis is crucial. All patients with signs of pancreatic necroses during adbominal ultrasound and patients with organ insufficiencies should undergo a CT-scan to define exactly the nature and the extent of disease. Primarily all patients are treated conservatively. Main indications for operative internation are signs for infections of pancreatic necroses and an acute abdomen due to local complications of acute pancreatitis. In cases of biliary origin an elective cholecystectomy has to be performed during a free interval to prevent a recurrence.