Complications of Laparostomy in Diffuse Peritonitis
Severe, diffuse, bacterial peritonitis remains a central problem in abdominal surgery, as does acute necrotizing pancreatitis, despite all of the advances in intensive care medicine. These illnesses are invariably associated with a very high mortality, up to 70% [1,3]. In principle the surgical therapy of diffuse peritonitis involves the operative elimination of abdominal sepsis by cleansing the peritoneal cavity of faecal and bacteria-rich exudate, but in some cases primary sterilization of the peritoneal cavity (or pancreatic bed, as the case may be) is inachievable. In these cases planned relaparotomy or leaving the abdomen open, i.e. by laparostomy, becomes necessary [2,3]. While in the case of necrotizing pancreatitis, severity grades II to III, we have had excellent success with laparostomy, drastically reducing mortality from 70% to 18.6% (Waclawiczek et al., this volume), we have had relatively poor results with diffuse peritonitis due to the generally complicated postoperative course. In this paper we would like to report these complications.
KeywordsPeritoneal Lavage Necrotizing Pancreatitis Open Abdomen Perforated Appendicitis Acute Necrotizing Pancreatitis
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