The Importance of the Surgical Moment in Infected Severe Acute Pancreatitis

Aims: The purpose of this study is to analyse the impact of the surgical moment in the management of suppurated acute pancreatitis (SAP) based on the comparison of the treatment in SAP between three distinct groups relative to the period between the onset of the disease and the day of surgery. The data from this study were gathered from patients in two periods: 1994-1999 (retrospective) and 2000-2011 (prospective). Methods: Among the 285 patients whit SAP admitted and treated in the two departments, 224 (78.6%) were submitted to the surgical intervention with various surgical indications. There is an obvious difference between the retrospective and prospective periods concerning the indication of surgery and mostly the time for surgery. The lots were analyzed concerning the aetiology, management of treatments and specific treatments.Results: There were analyzed: the period of time between the onset of the disease and the surgical intervention, the status of the patients at the surgical moment, the global mortality based on the timing of surgery, the evolution of the management of SAP along the period of the research, comparisons whit the literature. The registered data were statistically processed using the SPSS test version 17 for Windows.Conclusion: The casuistry in the studies does not show significant differences between the two periods regarding the gravity of the acute episodes of the disease which could influence the difference of the therapeutical results. The most important factor related to the postoperative outcome seems to be the timing of surgery in the management of SAP.