Laparoscopic treatment of severe acute pancreatitis.

Background. Aim of our study was to evaluate possibilities and importance of laparoscopic surgery in treatment of severe acute pancreatitis. Methods. From November 1998 till November 1999 were treated 32 patients (20 male, 12 female, median age 41) with severe acute pancreatitis (21 - toxic pancreatitis, 11 - biliary pancreatitis). 15 patients were operated. 12 of them laparoscopically (4 - toxic pancreatitis, 8 - biliary pancreatitis). Results. In 3 cases laparoscopic opening and drainage of lesser sac, 11 cases laparoscopic drainage of abdominal cavity, 8 cases laparoscopic cholecystectomy, 6 cases laparoscopically assisted jejunostomy were pet-formed. In laparoscopic group conversion rate 2 from 12 (24%); one to confirm localization of lesser sac drain, which retrospectively was in proper localization; second - lack of operating space due to severe peripancreatic infiltration. Complications rate 1 from 12 (12%); open drainage of peripancreatic abscess in postoperative period. Laparoscopically operated group - no mortality. Overall mortality 2 from 32 (6.25%). Conclusion, Laparoscopic drainage of lesser sac abdominal cavity as well laparoscopically assisted jejunostomy in patients with severe acute pancreatitis is technically possible, decreases operation trauma, improves postoperative recovery and is good alternative to open procedure.