Laparoscopic treatment of severe acute pancreatitis.

The appropriate surgical treatment for severe acute pancreatitis has been disputed for a long time. Herein we describe our experience with the laparoscopic treatment of this disease. Ten patients, seven male and three female, with an average age of 55 years were diagnosed with severe acute pancreatitis. All cases but one were found to be without biliary stones by ultrasonic and CT scans. Laparoscopic exploration, irrigation, drainage, and decompression of the pancreas were performed. Further treatment, including gastric decompression, irrigation via the drainage tubes, antibiotics, somatostatin, and parenteral nutrition, was continued in all patients following the laparoscopic procedures. Nine patients recovered successfully; one died from adult respiratory distress syndrome (ARDS) soon after the operation. The hospital stay was 10-30 days. The laparoscopic era offers new hope for the treatment of severe acute pancreatitis. The technique can be used to determine the pathologic extent of the disease, to irrigate and drain the abdominal cavity, and to decompress the pancreas. Almost every surgical procedure for acute pancreatitis can be performed laparoscopically.