Surgical treatment of severe necrotizing pancreatitis by the method of "open abdomen"--early and long-term results.

The aim of our study was the evaluation of "open abdomen" method (OAM) in treatment of severe acute pancreatitis. Fifty patients were treated by this technique in our Department from 1983 to 1999 year. Patients were retrospectively classified into 3 groups: with sterile pancreatic necrosis (SPN), pancreatic abscess(PA) and infected pancreatic necrosis(IPN). Early results embraced: number of local and general complications and a lot of parameters, which let to recognise objectively efficiency of management(time of hospital and intensive care unit stay, time of total parenteral nutrition, number of reoperations and others). These results were compared with analogical groups, in which used other management. Long-term results embraced the pancreatic efficiency tests in 24 patients in period 2-16 years after surgical treatment of OAM. Based on these results three groups of patients were separated: 12 persons (50%) recognised healthy, 4 (17%) with exocrine insufficiency of pancreas and 8 (33%) with exocrine and endocrine insufficiency of pancreas. Our results prove that OAM is the efficient treatment of IPN, but it shouldn't be used in cases of PA or SPN. Patients after OAM need prospective monitoring of exocrine and endocrine pancreatic function due to serious risk of this organ dysfunction.