Surgical strategies in severe acute pancreatitis (SAP): indications, complications and surgical approaches.

摘要: BACKGROUND Severe acute pancreatitis (SAP) is still related to high mortality rates. This study evaluated the various surgical strategies for treatment of suspected infected necroziting (INP). METHODS retrospective included 212 patients with SAP and INP, who had during period between January 2000 - December 2012 at Ist Surgical Clinic. approaches laparostomy continous postoperative retropancreatic lavage, open abdomen strategy, laparotomy primary abdominal closure accompanied or not by (marsupialization), retroperiostomy retroperitoneal lavage. RESULTS The overall rate was 34.0 percent, 24 percent in lavage,11 retroperitoneostomy 71 strategy,and 43 closed abdomen(p 0.001). Acute operations, alcoholic origin, Apache II scores ‰¥10 organ dysfunction on admission were independent factors that predisposed complications.Colonic necrosis rates (53 percent), however seemed be prognostic relevance. CONCLUSIONS conservative approach severe acutepancreatitis a promising therapeutic concept. Delaying surgery up third week after onset disease significantly improves patients€™ survival. Complications are common necrotizing leading failure need operations. Colonic necros an factor