Necrosectomy and postoperative local lavage in XXXX .

@entity1 @entity788 @entity295 @entity656 @entity39 @entity281 @entity1850
The severity of @entity656 is correlated to the amount of necroses--pancreatic parenchymal necroses and fatty tissue necroses in the retroperitoneal spaces--the liberation of vasoactive and toxic substances and the bacterial contamination of necroses. The @entity39 pancreatits occurs in around 15 to 25% of all @entity1 with @entity656 ; a @entity281 has been observed in around 40% of @entity1 with @entity788 . Surgical treatment in @entity1 with @entity788 is indicated, if they develop a surgically acute abdomen, a @entity1850 or a multisystem's organ failure syndrome despite ICU-treatment over at least 3 days. Bacterial contamination, proved by an ultrasound guided FNP of the @entity39 is a strong indicator for surgical management. Careful necrosectomy and a continuous local lavage of the lesser sac and the @entity39 are most effective. Conservation of vital pancreatic tissue is a major goal of surgical treatment. The continuous local postoperative closed lavage results in a continuous evacuation of vasoactive and toxic substances, bacteria, local active enzymes and debrid tissue. Among @entity1 with sterile pancreatic necroses only those with major necroses of more than 50% of the pancreas are candidates for surgical treatment. Hospital mortality after necrosectomy and local lavage figures in major leading series between 8 and 20%. Failure of surgical treatment of @entity788 is mostly due to continuing local and systemic @entity295 .
