Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Importance of peritoneal irrigation after surgical treatment of hemorrhagic, necrotizing pancreatitis

  • 31 Accesses

  • 19 Citations

Abstract

This is a report of 139 patients with hemorrhagic, necrotizing pancreatitis, 135 of whom were operated upon. The poorest results (mortality rate of 64%) were found in patients with total necrosis of the gland, while partial necrosis of the pancreas had a better outcome (33% mortality rate). The most favorable form of therapy was either local excision of necrotic pancreatic tissue (necrosectomy), or left resection of the pancreas, combined with postoperative irrigation and sump drainage of the peritoneal cavity. With this technique, the mortality rate of 72% seen with drainage of the peritoneal cavity alone was reduced to 33%.

Résumé

Sur 139 malades atteints de pancréatite hémorragique nécrosante, 135 ont été opérés. Les résultats les plus mauvais ont été obtenus dans les cas de nécrose complète de la glande (mortalité 64%); le pronostic est meilleur lorsque la nécrose est partielle (mortalité 33%). Les thérapeutiques les plus favorables sont l'excision locale du tissu pancréatique nécrosé (nécrosectomie) ou la pancréatectomie gauche, avec irrigation et drainage postopératoire de la cavité péritonéale. Ces techniques donnent une mortalité de 33% alors que le seul drainage péritonéal donnait 72% de décès.

This is a preview of subscription content, log in to check access.

References

  1. 1.

    Lankisch, P.G., Koop, H., Winckler, K., Schmidt, H.: Continuous peritoneal dialysis as treatment of acute experimental pancreatitis in the rat. I. Effect on length and rate of survival. Dig. Dis. Sci.24:111, 1979

  2. 2.

    Lankisch, P.G., Koop, H., Winckler, K., Schmidt, H.: Continuous peritoneal dialysis as treatment of acute experimental pancreatitis in the rat. II. Analysis of its beneficial effect. Dig. Dis. Sci.24:117 1979

  3. 3.

    Ancarani, E., Tersigni, R., Vincenti, R.: Peritoneal dialysis in the treatment of experimental acute pancreatitis. Bull. Soc. Int. Chir.31:142, 1972

  4. 4.

    Rasmussen, B.L.: Hypothermic peritoneal dialysis in the treatment of acute experimental hemorrhagic pancreatits. Am. J. Surg.114:716, 1967

  5. 5.

    Rogers, R.E., Carey, L.C.: Peritoneal lavage in experimental pancreatitis in dogs. Am. J. Surg.111:792, 1966

  6. 6.

    Rosato, E.F., Chu, W.H., Mullen, J.L., Rosato, F.E.: Peritoneal lavage treatment of experimental pancreatitis. J. Surg. Res.12:138, 1972

  7. 7.

    Rosato, E.F., Mullis, W.F., Rosato, F.E.: Peritoneal lavage therapy in hemorrhagic pancreatitis. Surgery74:106, 1973

  8. 8.

    Hollender, L.F., Kohler, J.H., Klein, A.: Zur chirurgischen Behandlung der akuten, nekrotischen Pankreatitis. Chirurg43:256, 1972

  9. 9.

    Kümmerle, F., Neher, M., Schönborn, H., Mangold, G.: Vorzeitige Operation bei akuter hämorrhagischnekrotisierender Pankreatitis. Dtsch. Med. Wochenschr.100:2241, 1975

  10. 10.

    Boutelier, Ph.: Les nécroses pancréatiques gauches. Lyon Chir.73:187, 1977

  11. 11.

    Kraft-Kinz, J., Zalaudek, H.: Chirurgie bei hämorrhagisch nekrotisierender Pankreatitis. Read at the Fourth Symposium Aktuelle Chirurgie, West Berlin, November 23–24, 1979

  12. 12.

    Höfler, H.: Pankreasnekrose: Todesursachen, Überlebenszeit und Wahl des Operationszeitpunktes. Dtsch. Med. Wochenschr.104:315, 1979

  13. 13.

    Hollender, L.F.: Wandel in der Behandlung der akuten Pankreasnekrose. Fortschr. Med.95:1029, 1977

  14. 14.

    Vankemmel, M.: Traitement chirurgical des pancreatites aiguës. Ann. Chir.30:607, 1976

  15. 15.

    Ranson, J.H.C., Spencer, F.C.: The role of peritoneal lavage in severe acute pancreatitis. Ann. Surg.187:565, 1978

Download references

Author information

Correspondence to Priv.-Doz. Dr. med. Christoph Gebhardt M.D..

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Gebhardt, C., Gall, F.P. Importance of peritoneal irrigation after surgical treatment of hemorrhagic, necrotizing pancreatitis. World J. Surg. 5, 379–382 (1981). https://doi.org/10.1007/BF01658005

Download citation

Keywords

  • Mortality Rate
  • Pancreatitis
  • Peritoneal Cavity
  • Local Excision
  • Pancreatic Tissue