Treatment of intra-abdominal sepsis and necrotizing pancreatitis with staged lavage using a Zipper

Vermassen, F.; Meerschaut, D.; Van Landuyt, K.; Pattijn, P.; Derom, F.

Acta Chirurgica Belgica 89(2): 77-81

1989


ISSN/ISBN: 0001-5458
PMID: 2756805
Document Number: 338136
The mortality of generalised intra-abdominal sepsis and severe necrotising pancreatitis remains very high. The persistence of intra-abdominal septic foci leads to recurrent abscess formation, persistence of sepsis and development of multiple organ failure, ultimately leading to the death of the patient. Therefore we believe that a repeated and total elimination of all septic and necrotic material is the cornerstone of an adequate surgical therapy in these patients. We performed "staged lavage" with the aid of a Zipper in 24 patients (10 with intra-abdominal sepsis and 14 with severe necrotising pancreatitis). Via the Zipper 98 relaparotomies were performed (mean 4.1 per patient). The high Apache II-scores (12 to 45, mean 24) illustrate the severity of disease in most of these patients. The expected in-hospital mortality-rate was 59% while in our series 7 patients died on a total of 24 (28%).

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