Die Bedeutung der Bauchinnendruck-Messung bei schweren akuten Pankreatitiden

Aim: Evaluating the importance of intraabdominal pressure measurement in cases of severe acute pancreatitis and its use in determining indication for surgery. Methods: A retrospective evaluation of the treatment of patients with severe acute pancreatitis hospitalised at the Department of Surgery or the Department of Anaesthesiology and Resuscitation of the Charles University hospital in Pilsen during the last two years (from January 1st, 2002 to December 31st, 2003) was performed. Results: During this period, 63 patients with severe acute pancreatitis were hospitalised at both departments, among which 18 patients underwent an operation (28.6%), eight of them died (12.7%). In four of the 18 patients who underwent an operation the surgery was indicated due to progression of abdominal compartment syndrome (ACS) and all of these patients survived. Conclusions: At present, basic treatment of severe acute pancreatitis is considered to be conservative. The only generally accepted indication for surgery is an established infection of the necrotic tissue. In our presentation, we draw attention to those cases where the general condition of the patient deteriorates combined with a progression of ACS and where a decompressive laparotomy can improve the prognosis of the disease.