Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
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Report about the treatment of necrotizing pancreatitis in the years 1988 until 1991. A rigorous conservative therapy was preferred, so that only 8.6% of the 140 patients underwent surgery. In 11 cases a continuous venous-venous hemofiltration (CVVH) was applied to patients with most serious clinical course and multi-system failure. ⋯ The present results show, that, eliminating mediators by hemofiltration, system failure in connection with sterile necrosis can be treated with a good success rate. Therefore toxic organ failure should no longer be regarded as an imperative indication for operation. We recommend strict intensive care including CVVH and antibiotical prophylaxis for treatment of sterile necrosis, while surgical therapy should only be applied to patients with bacterial contamination of pancreatic necrosis.