Explorative Laparotomy Versus Conservative Management In Acute Pancreatitis


BACKGROUND Acute pancreatitis is common disease, the two major etiological factors responsible for acute pancreatitis are alcohol and cholelithiasis .Patients and methods This study was done in the emergency department (ED) in AL- Hussein. teaching- hospital ( Al Nassyria ) during 2 years (between 1st junuary 2009 to 31st December 2010) about 39 patients presented as acute abdomen proved later on as acute pancreatitis , all patients were presented to the emergency department with acut abdominal pain .19 patients had reports suggested that they had features suspected perforated viscus[a history of more than 72 hours of sever abdominal pain with abdominal distention,free fluid in the peritoneal cavity] so their conditions were mandated exploratory laparotomy . While the other ( 20 patient ) had less feature of abdominal distention, not dehydrated and near normal vital sign so they were postponed to the early morning and re-evaluated by C.T scan of the abdomen and complete evaluation of Ransons criteria which confirm that they had a cute pancreatitis and treated conservatively.Aim of study Comparison between conservative versus operative management in acut pancreatitis.Results Patients in group 1 (Conservatively managed patient ) required relatively less hospital stay than the patient in group 2 (explored patient),but complications like pseudo cyst of pancreas,bilateral pleural effusion occurs mores in group 1.Conclusion Early washout of abdominal cavity by explorotive surgery or other minimal access pruceduers was advocated in management of acute pancreatitis.