'Medical University Prof. Dr. Paraskev Stoyanov - Varna'
Doi
Abstract
Necrosis of the pancreas and the peripancreatic tissue is present in 10-20% of patients with acute pancreatitis (AP) and is the reason for the high levels of morbidity and mortality rate in these cases. In the initial phase of acute necrotizing pancreatitis (ANP), the most important moments in the treatment are permanent correction of fluid and electrolyte imbalance, early enteral nutrition, ERCP in patients with cholangitis and increased pressure in the biliary tract, and patient admission in intensive care unit. When pancreatic and peripancreatic necroses become infected, surgical treatment is an optimal option, which, if possible, should be delayed till the fourth week after the onset of the disease. The type of surgery also experienced changes - from a classic open approach, with the introduction of wide drainage for postoperative lavage, through half-open techniques with subsequent repeated laparotomy, to a percutaneous drainage with a subsequent access to the retroperitoneum to perform minimally invasive necrectomy
