Advantages and disadvantages of open and semi-open abdomen in acute pancreatitis

Abstract

Introduction: The study of clinical and laboratory evolution of patients diagnosed with severe acute pancreatitis (hemorrhagic -necrotic and suppurated) which have indication for surgical treatment with open or semi open abdomen and programmed re- intervention, advantages and disadvantages of applied methods. Acute pancreatitis as subject of this work was chosen because, by severity of the clinical picture, the reticent prognosis and high mortality after systemic effects of its severe form, it is known as “the great abdominal drama”, framing by its evolution and complications one of the forms of abdominal sepsis. Materials and methods: The study performed on a group of 30 patients diagnosed with severe acute pancreatitis, admitted to “Sfantul Apostol Andrei” Hospital of Galati, in Surgery 2 section, where they have been submitted to surgery and close/ semi opened drainage methods and programmed re-interventions. The patients’ clinic evaluation was performed according to the Ranson Criteria and APACHE. Results: Patients diagnosed with severe acute pancreatitis and their post surgical evolution remains a subject of scientific. Different opinions are not regarding the indication and optimal timing of surgery but how to achieve the drainage cavity and postoperative surgical follow. The indication of surgery timing is established upon the clinical criteria which we obtain according to Ranson Criteria and APACHE. Conclusions: The open abdomen method has as advantage the existence of a permanent access way to the pancreatic lodge, with secretion elimination and as well as contact with O2 which does not allow the development of anaerobic bacteria.