Necrotizing pancreatitis. Surgical indications and results in 118 patients

In a ten years period 118 patients were operated with necrotizing pancreatitis. 42% of the patients had a 50% necrosis and 25% a subtotal/total necrosis of the pancreas. Surgical therapy principally includes: necrotectomy with drainage of the pancreas layer and postoperatively local lavage of the pancreatitic cavum (61/24 h). In 28 patients a continuous peritoneal lavage were performed additionally (24.4 +/- 14.71/day, duration 9.6 +/- 8.2 days). The total lethality was 33.9%. The course of the patients with necrotizing pancreatitis is destinated by the extention of the necrosis in the pancrease itself, the development of extrapancreatic necrosis and the bacterial contamination of the necrosis (bacterial retroperitonitis, abscess).