ORIGINAL ARTICLES   

Minerva Chirurgica 2007 February;62(1):19-24

Copyright © 2007 EDIZIONI MINERVA MEDICA

language: Italian

Postoperative acute pancreatitis: our experience and review of the literature

Testi W., Staffieri C., Malatesti R., Macchitella Y., De Martino A., Botta G., Cirianni D., Genovese A., Bing C., Logatt M.

Dipartimento di Chirurgia Generale e Specialità Chirurgiche Università degli Studi di Siena, Siena

Aim. Acute postoperative pancreatitis is a rare event, but, at the same time, it represents one of the most frightening complications, because it is associated with high mortality risk.
Methods. From January 1985 to December 2005, we observed 30 cases (12 males, 18 females) of acute postoperative pancreatitis. Twenty cases of low and medium gravity have been treated with only medical therapy, 10 cases, instead, have requested surgical therapy (necrosectomy and application of abdominal drains in 7 cases, necrosectomy and ileostomy in 1 case, necrosectomy and colostomy in 1 case, ligation of pancreatic vessels in 1 case of haemorragic pancreatitis).
Results. In the form of low and medium gravity, fast and pharmacological support (somatostatin and gabexate mesilate) are enough to resolve the event. In the form of high gravity the early surgical treatment has represented the clinical solution in 7 patients, while 3 others patients have died for septic and metabolic complication.
Conclusion. Still today acute postoperative pancreatitis represents a frightening complication associated with high mortality risk that the surgeon have to treat with great care to avoid each bilio-pancreatic injury.