J.Jpn. Surg. Soc.. 86(9): 1265-1268, 1985

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Report on the annual meeting

SFURGICAL RESULTS OF SEVERE ACUTE PANCREATITIS WITH
SPECIAL CONSIDERATION OF SEVERITY
OF PANCREATITIS

The surgical treatment of acute pancreatitis remains controversial Since 1975, we have treated 70 patients with acute pancreatitis. In 36 with severe acute pancreatitis who were not responding adequately to medical intensive treatments, mobilization and drainage of pancreatic exudate from pancreatic bed and retroperitoneal cavity (M-D procedure) were carried out. Thirty-six operative cases were classified into 8 edematous, 7 hemorrhagic, and 21 necrotizing. Edematous pancreatitis showed a tendency of early development of severe symptoms such as enzymatic encephalopathy. Eight of 36 patients who underwent M-D procedure died (22.2 per cent), but the rate became 13.8 per cent after excluding 3 who died of unrelated causes. Postoperative complications were most frequently encountered in the patients with gall sone pancreatitis. Obstrruction of the alimentary tract due to pancreatic or peripaancreatic abscess was most serious late complication. Six of the eight were required reoperations and three of them died of further complications which were developed after reoperations.
The rate of curability of M-D procedure was 84.8 per cent. These data suggest that M-D procedure is highly effective in the treatment of early case of severe acute pancreatitis.

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