Resumen

BARREDA CEVASCO, Luis Alberto, TARGARONA MODENA, Javier y RODRIGUEZ ALEGRIA, César. Tratamiento Quirúrgico de la Necrosis Pancreática en el Hospital Nacional Edgardo Rebagliati Martins. Rev. gastroenterol. Perú, abr./jun. 2002, vol.22, no.2, p.120-127. ISSN 1022-5129.

We present a review of 41 cases of Severe actue pancreatitis with pancreatic necrosis. This study was based on the use of closetd surgery technique with continuous irrigation and rescheduled relaparatomies. The study was divided into two stages :the first one with 20 patients with no work protocol and the second one with 21 patients with a "strict protocol " .The post-surgical morbility and the morbitaly were evaluated .There 21 male patients and 20 famale patients.The predominant etiology was the related to the biliary tract.The Rason and APACHE II criteria had no predictive value for mortality, with showed a decreased rate during the the second stage of the study. Furthermore, the protocol used in the two stages and the surgical technique used on the 41 patients have been described, as well as the severety of pancreatitis and the surgical indications in each case. We conclude that a "strict protocol " of pre-operative management and puncture with a pre-operative fine needle -in combination with the surgical technique proposed-significantly decreases the mortabily due to severe acute pancreatitis.

Palabras llave: Actue pancreatitis; necrotic pancreas; surgical therapy.