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Neue chirurgische strategie zur behandlung der akuten nekrotisierenden pankreatitis

A new strategy in treating acute necrotizing pancreatitis—immediate operation, retroperitoneostomy, programmed revisions

Sofortoperation, retro-peritoneo-stoma, programmierte revisionen

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Zusammenfassung

20 patienten mit schwerer, akuter, hämorrhagisch-nekrotisierender pankreatitis wurden im rahmen einer prospektiven studie mit sofortoperation, anlegen eines retroperitoneostomas (RPS) und programmierten revisionen behandelt. Die letalität betrug 15%. Die prognose war abhängig vom schweregrad der pankreatitis, vom abstand zwischen beginn der erkrankung und der notwendigen Sofortoperation, vom vorliegen einer primären bakteriellen besiedelung, dem auftreten von komplikationen, von organinsuffizienzen oder-versagen. todesursache der 3 verstorbenen patienten war ein hypodynamer, septischer schock mit mehrfachorganversagen.

Summary

20 patients with acute, severe, necrotizing pancreatitis entered a prospective study and were treated by immediate operation, retroperitoneostomy and nonmandatory programmed revisions. Lethality was 15%. The clinical course and prognosis were essentially dependent on the time between first symptoms and the necessary immediate operation, extent of necrosis in the pancreas itself, the development of extrapancreatic necrosis, bacteriological status of the necrotic area, complication frequency and development of multiple system organ failure (MSOF). 3 patients died because of hypodynamic septic shock with consecutive MSOF.

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Funovics, J., Feil, W. & Sporn*, P. Neue chirurgische strategie zur behandlung der akuten nekrotisierenden pankreatitis . Acta Chir Austriaca 18, 442–452 (1986). https://doi.org/10.1007/BF02656374

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  • DOI: https://doi.org/10.1007/BF02656374

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