Evaluation of Laparoscopic Management of Acute Necrotizing Pancreatitis

Abstract

Background: Acute pancreatitis is defined as an inflammatory process that involves the pancreas, peripancreatic tissues and less commonly other organ systems with increasing incidence globally. It is usually a self-limiting disease, however 25 % of patients will develop a potential life threating complication like pancreatic necrosis. Surgical debridement and drainage is advised for symptomatic necrosis with clinical deterioration with continuous postoperative closed lavage. Over the past decade minimally invasive approach for drainage and evacuation of pancreatic necrosis has dramatically evolved. The aim of this study was to evaluate the safety and efficacy of laproscopic management of acute necrotizing pancreatitis. Patients and methods: This prospective interventional non-controlled study was conducted in the Department of General Surgery at Ain Shams University hospitals in the period from June 2012 to July 2016 on twenty-four patients (15 males and 9 females). All our patients presented with acute necrotizing pancreatitis. Informed consent was obtained from all patients included in the study. Operative time, hospital stay, re-exploration and other factors were recorded. Results: Out of 24 cases 15 were men (62.5%), 9 were women (37.5%) with age ranging from 28-60 years (average 42.7). In twenty-one cases (87.5%) gall stones were the cause of necrotizing pancreatitis, two cases were due to excess alcohol (8.33%) and one case (4.16%) was idiopathic. Twenty cases (83.33%) were completed laparoscopic while four cases (16.66%) were converted to open, two cases (83.33%) developed pancreatic fistula and mortality was three cases (12.5%). Conclusion: Laproscopic management seems to provide a safe and efficient option for treatment of acute necrotizing pancreatitis.