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RESEARCH PRODUCT

Management of complications after operations for acute pancreatitis.

subject

description

After early operation in 49 patients and delayed operation in 114 patients, all with acute hemorrhagic-necrotizing pancreatitis, 65% of patients developed local or general complications. Local complications were abscesses, peritonitis, bleeding, gastrointestinal fistulae or stenoses, and external pancreatic fistulae. Their cause can be traced to the large wound cavity with the tryptic wound surface as well as residual necrosis. The general postoperative complications were shock, acute renal failure, cardiorespiratory insufficiency, gastrointestinal bleeding, ileus, coagulopathy, and sepsis. These may have resulted from the local complications, or may even have been present before operation. If local septic complications do not respond to conservative treatment, they require reoperation. For gastrointestinal fistulae or stenoses, or for pancreatic fistulae, a “wait and see” attitude is recommended. Generalized complications call for aggressive intensive medical care.