NECROSECTOMY AND LAPAROSTOMA AS A SURGICAL-TREATMENT CONCEPT FOR ACUTE NECROTIZING PANCREATITIS

121 patients with acute necrotizing pancreatitis were treated according to a surgical regimen of necrosectomy, drainage by laparostomies and repeated revisions. Changing the protocol from revisions on demand to scheduled reexplorations resulted in an improvement of mortality from 53% to 28%. The high incidence of gastrointestinal fistulas (30%) associated with this regimen could be decreased to 5% by a more individual protocol with longer intervals of revisions in the later course. Mortality was 21% following this regimen.