Medical versus surgical management for emphysematous pancreatic necrosis: is gas within pancreatic necrosis an absolute indication for surgery?

Objectives: The aim of this study was to evaluate whether pancreatic necrosis with presence of gas is an absolute indication for surgery or if there is a possibility for the medical management of this pathology.

Methods: This study is a retrospective study including 56 patients with diagnosis of pancreatic necrosis and gas on computed tomography from April 2003 to March 2011. We recorded all the factors related to each group of treatment, including APACHE II score, C-reactive protein level, Tomographic Severity Index, organ and multiorgan failure, and infected necrosis after fine-needle puncture, to evaluate the differences between surgical and medical treatment.

[Impact of duodenopancreatectomy in elder patients].

Unlabelled: The incidence of periampullary neoplasms substantially increases with age. If we take into account that this incidence is higher in the elder patient and that life expectancy is nowadays longer, questioning surgical approach in this group of patients turns out to be controversial.

Objective: [corrected] Asses if in the elder patients the duodenopancreatectomy has a higher mortality and complications.

[Is Peng's pancreaticojejunal anastomosis more effective than mucosa-mucosa anastomosis in duodenopancreatectomy for pancreatic and peri-ampullary tumours?].

Introduction: The pancreatic fistula is the most feared complication after a duodenopancreatectomy, and is the most common independent factor of post-surgical mortality. Peng et al. recently published a pancreaticojejunal anastomosis technique (binding anastomosis) which showed 0% pancreatic fistulas.

[Evaluation and validation of surgical indications in acute pancreatitis with necrosis, at the National Hospital Edgardo Rebagliati Martins].

Objective: The purpose of this study is to evaluate efficacy of the surgical indications in acute pancreatitis.

Material And Methods: During the period from May 2000 to June 2009, 107 operated patients with pancreatic necrosis were treated in the Severe Acute Pancreatitis Unit of the HNERM a comparison was made by separating the patients in two groups according to the surgical indication. An analysis was carried out in order to evaluate which type of surgical indication has the best results according to age, severity of the case, return to oral intake, hospital stay, complications and mortality.