Laparoscopic Management of Acute Necrotising Pancreatitis - a Case Report

Abstract

Introduction: Most cases of acute pancreatitis (80%) are self-limiting and susceptible to medication. The rest develop a severe form of the disease with the formation of pancreatic necrosis. Materials and Methods: A 74-year-old female was admitted to our clinic with complaints of abdominal bloating and impossible food and fluid intake. She had undergone a previous conservative treatment for acute pancreatitis in a therapeutic ward. The onset of the disease had been dated back to about 50 days prior to the surgery clinic admission.Results and Discussion: The CT revealed a lesser-sac abscess and necrosis of the head and body of the pancreas. Due to age and comorbidity issues a laparoscopic approach was chosen. A lesser-sac abscess, total necrosis of the head and body and partial necrosis of the tail of the pancreas were found. A laparoscopic evacuation of the abscess, followed by a subtotal proximal pancreatonecrectomy, was performed. The six-month follow-up evaluation showed good general health and no evidence of complications.Conclusion: The severe form of acute pancreatitis remains one of the most difficult to manage benign diseases of the GI tract, requiring multidiscipline approach with controversial treatment results. Ðœinimally invasive operative techniques contribute to a shortened hospital stay, surgical trauma reduction and a better treatment outcome.