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.
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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
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DOI: https://doi.org/10.1007/BF01658005