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Intraperitonealisation of pancreas and multiple coeliostomy--a possible approach to reduce mortality of acute necrotizing pancreatitis.

The authors report their experience with surgical treatment of acute necrotizing pancreatitis. 207 of 411 patients with acute pancreatitis were operated upon. Acute necrotizing pancreatitis was found in 126 individuals. The following surgical procedures were used: subtotal spleno-pancreatectomy in 26 cases (20.6 per cent), necrectomy or sequestrectomy in 25 cases (19.7 per cent), and conservative procedures, including drainage or incision of the pancreatic capsule, in 76 cases (70.6 per cent). Most of the operations were delayed emergency interventions. The authors found adequate exposure of the pancreas as well as on proper drainage of the lesser sac and retroperitoneal areas essential. This can be accomplished by means of the authors' procedure called "intraperitonealisation" of the pancreas and by multiple coeliostomy.