[Role of the severity score and of the multiple organ dysfunctions in the treatment of severe acute pancreatitis and its infective complications].

Introduction: There is considerable controversy about timing of surgery in acute pancreatitis. Scoring system is widely used in Intensive Care Units (ICU) but above all in order to assess the severity of disease.

Aim Of The Study: In this prospective clinical study, modification of clinical evolution and scores (APACHE II, SAPS II and SOFA) are analyzed.

Predictive value of a pathophysiological score in the surgical treatment of perforated diverticular disease.

Resection is the preferred method of perforated diverticular disease treatment compared to conservative treatment. However, the immediate or deferred timing of bowel continuity restoration for advanced degrees of peritoneal contamination is debatable. This is a retrospective study designed to identify operative mortality predictors and guidelines for safe primary anastomosis.

[Open treatment in acute severe pancreatitis].

Technical procedures normally used for open packing in our Institute (ICU) are described. Results of this procedure, utilized in thirteen patients suffering from infected pancreatic necrosis and multiple organ failure are reported. The grade of pancreatitis severity has been studied in detail.

The choice of surgical procedure for peritonitis due to colonic perforation.

Objective: Because the choice of surgical procedure for colonic perforation is still matter of debate, we retrospectively studied peritonitis caused by spontaneous colonic perforation to assess predictors of mortality and the safety of primary resection and anastomosis.

Design: Case series.

Patients: We investigated one hundred thirty-six consecutive patients with peritonitis due to colonic perforation who were surgically treated in an emergency surgery department.