Planned reoperative necrosectomy/debridement for necrotizing acute pancreatitis with delayed primary closure

M. G. Sarr

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Management of the peripancreatic bed after necrosectomy for surgical complications of acute necrotizing pancreatitis remains controversial. Since 1985, we have adopted a technique of planned, reoperative necrosectomy/debridement with eventual primary wound closure over peripancreatic drains. Using this approach in 47 patients, we have experienced an operative mortality of 23% and a recurrent intra-abdominal abscess rate of 13%, all but one of which were treated by simple percutaneous drainage. In contrast, 18 patients were managed by a single operative necrosectomy with placement of peripancreatic drains; their operative mortality was 33%, and all 3 patients who developed intra-abdominal abscesses required reoperation. We believe that a planned reoperative necrosectomy with eventual primary abdominal closure maximizes the success of complete necrosectomy and minimizes the incidence of recurrent (or persistent) intra-abdominal sepsis.

Original languageEnglish (US)
Pages (from-to)252-256
Number of pages5
JournalDigestive Surgery
Volume11
Issue number3-6
DOIs
StatePublished - Jan 1 1994

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Keywords

  • Necrosectomy
  • Necrotizing pancreatitis

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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