Progress in the management and treatment of infected pancreatic necrosis

G. Farkas, J. Márton, Y. Mándi, E. Szederkényi, Á Balogh

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29 Citations (Scopus)

Abstract

Infected pancreatic necrosis and sepsis are the leading causes of mortality in necrotizing pancreatitis. A review has been undertaken of the results of the past two decades relating to different surgical treatments of infected pancreatic necrosis. During the period 1978-85, the surgical treatment of necrotizing pancreatitis and its complications in our department consisted of the 'conventional' therapy (resection of the involved pancreatic tissue, or necrosectomy and drainage) in 61 patients, with a mortality rate of 36% (22 patients died). Since 1986, we have performed necrosectomy and other surgical interventions combined with continuous widespread lavage in 142 patients with infected pancreatic necrosis. The overall mortality decreased significantly to 6.3% (9 patients died). This result was achieved by means of aggressive surgical treatment, continuous, prolonged washing and suction drainage and supportive therapy, including immunonutrition, modifying the cytokine production arid adequate antibiotic and antifungal medication. This surgical strategy provides the possibility for recovery in cases of necrotizing pancreatitis with septic complications.

Original languageEnglish
Pages (from-to)31-37
Number of pages7
JournalScandinavian Journal of Gastroenterology, Supplement
Volume33
Issue number228
Publication statusPublished - Dec 15 1998

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Keywords

  • Candida infection
  • Cytokine production
  • Infected pancreatic necrosis
  • Pancreatitis
  • Pentoxifylline
  • Surgical management

ASJC Scopus subject areas

  • Gastroenterology

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