Acute Fulminant Pancreatitis: Debridement or Formal Resection of the Pancreas

During the ten year period from 1980 to 1989, 51 patients were treated at Oulu University Central Hospital for fulminant acute pancreatitis. Five were in a moribund state on admission and died shortly afterwards, 6 were treated conservatively and survived, and 40 were operated on, 17 by primary pancreatic resection and 23 by debridement of the peripancreatic area. Mortality rates were 53 per cent for the resection group and for the debridement group 22 per cent. Reoperations were performed in 24 per cent of patients in the pancreatic resection group and in 60 per cent of those in the debridement group. The high mortality rate associated with primary pancreatic resection has caused us to adopt a more conservative strategy, and surgical treatment is directed towards later complications of this severe disease.