Early definitive surgery in the management of severe acute pancreatitis

Abstract

Objective: To assess the role of early peritoneal lavage and drainage in the management of severe acute pancreatitis.

Data sources: Early peritoneal lavage and drainage was defined as that lavage and drainage should be done in the peritoneal cavity without interference of the pancreas within 72 hours after onset of acute pancreatitis. Biomedical literature database (Medline) from 1981 through 2003 was retrieved and papers about this treatment were analyzed.

Results: Nine papers retrieved included 179 patients with severe acute pancreatitis. In 108 patients undergoing closed peritoneal lavage and drainage, 7 died, in 15 patients having laparoscopic procedure, 1 died, and in 56 patients having open procedure 2 died. The total survival rate was 94.4%.

Conclusions: Even if extensive pancreatic necrosis occurs, early peritoneal lavage and drainage is feasible to keep the inflammatory pancreas intact and drain peri-pancreatic region in an attempt to improve the survival rate.