EXPLORATIVE LAPAROTOMY VERSUS CONSERVATIVE MANAGEMENT IN ACUTE PANCREATITIS

Abstract

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 1^st   junuary  2009 to 31^st 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.