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Rubtsov MA, Galeev SI. Surgical Approach to Treatment of Necrotizing Pancreatitis: Early Primary Drainage without Necrosectomy. Review of Seven Recent Cases. Case Rep Gastroenterol. 2009;3(1):97-104doi: 10.1159/000212991.
Rubtsov, M. A., & Galeev, S. I. (2009). Surgical Approach to Treatment of Necrotizing Pancreatitis: Early Primary Drainage without Necrosectomy. Review of Seven Recent Cases. Case reports in gastroenterology, 3(1), 97-104. https://doi.org/10.1159/000212991
Rubtsov, M A, and Galeev, S I. "Surgical Approach to Treatment of Necrotizing Pancreatitis: Early Primary Drainage without Necrosectomy. Review of Seven Recent Cases." Case reports in gastroenterology vol. 3,1 (2009): 97-104. doi: https://doi.org/10.1159/000212991
Rubtsov MA, Galeev SI. Surgical Approach to Treatment of Necrotizing Pancreatitis: Early Primary Drainage without Necrosectomy. Review of Seven Recent Cases. Case Rep Gastroenterol. 2009 Apr 17;3(1):97-104. doi: 10.1159/000212991. PMID: 20651973; PMCID: PMC2895184.
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Case Rep Gastroenterol. 2009 Apr 17;3(1):97-104. doi: 10.1159/000212991.

Surgical Approach to Treatment of Necrotizing Pancreatitis: Early Primary Drainage without Necrosectomy. Review of Seven Recent Cases.

Case reports in gastroenterology

M A Rubtsov, S I Galeev

Affiliations

  1. Saint-Lucas Clinical Hospital, Saint Petersburg, Russian Federation.

PMID: 20651973 PMCID: PMC2895184 DOI: 10.1159/000212991

Abstract

Unsatisfactory results of surgery in the late course of pancreatic necrosis made us search for indications and variants of operation in the early phase of the disease. As early surgical intervention, the universal approach was used in 7 patients with necrotizing pancreatitis who had a different prevalence of the inflammatory process in the retroperitoneal space. The drainage proved to be effective and enabled us to always prevent generalized infectious complications in the later phases of the disease in absence of local complications specific for open surgery: bleeding and digestive fistulas. In spite of obvious infected process development in primary open surgery, we noticed a stable decrease in procalcitonin level following the drainage. A surgical intervention has been developed enabling one to reveal in time the volume of damaged retroperitoneal fat tissue and to drain it adequately in compliance with the process prevalence, thus avoiding septic complications in the late phase of the disease. The method's advantage involves refusal from necrosectomy in primary intervention, weekly staged revisions of the retroperitoneal space via formed contrapertures as dictated by evolution of the necrotic process in the gland.

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