[Surgical treatment of pancreatic necrosis at Edgardo Rebagliati Martins National Hospital]. / Tratamiento quirúrgico de la necrosis pancreatica en el Hospital Nacional Edgardo Rebagliati Martins.

We present a review of 41 cases of severe acute pancreatitis with pancreatic necrosis. This study was based on the use of closed surgery technique with continuous irrigation and rescheduled relaparatomies. The study was divided into two stages: the first one with 20 patients with no work protocol and the second one with 21 patients with a "strict protocol". The post-surgical morbility and the mortality were evaluated. There were 21 male patients and 20 female patients. The predominant etiology was the related to the biliary tract. The Ranson and APACHE II criteria had no predictive value for mortality, which showed a decreased rate during the second stage of the study. Furthermore, the protocol used in the two stages and the surgical technique used on the 41 patients have been described, as well as the severity of pancreatitis and the surgical indications in each case. We conclude that a "strict protocol" of pre-operative management and puncture with a pre-operative fine needle -in combination with the surgical technique proposed- significantly decreases the mortality due to severe acute pancreatitis.