[Postoperative acute pancreatitis (PAP). Direct personal experience]

Abstract

Eight different cases of APP observed after intervents made near the pancreas (partial gastrectomy for ulcer, papillosphincteroplasty, DCP) are presented. The clinical stage, the therapeutic attempts, the results are studied. The clinical stage, the therapeutic attempts, the results are studied. In order to value the role of the pancreatic trauma in causing the APP the Authors have checked in addition 14 cases in which a direct action on the pancreas was present. In these cases noticeable amylasemic increases have not been observed except one cases of APP after DCP. Hypothesizing the role of a duodenal hyperpressure in causing the reflux of duodenal juice into the Wirsung then in causing an APP, the Authors report the results obtained after the introduction of a catheter into the duodenum in order to make it empty untily the renewal of peristalsis, during the papillosphincteroplasty and partial gastrectomy for ulcer. The Authors suggest that the duodenal emptying could be a method to prevent the APP. The prevention by the usually adopted drugs as aprotininum and glucagonum was ineffective, as well as other surgical techniques. High mortality: 5 cases on 8.