Morphological Aspects of Necrosis as a Guideline for Treatment of Necrotizing Pancreatitis (A Brief Report About 50 Patients)

In a retrospective study, 50 patients withobvious necrotizing pancreatitis (NP) were allocated infour groups according to the morphological aspects ofthe necrosis. Appearance of ascite (N1), extrapancreatic spread of necrosis towards neighboring organs(N2), a large amount of necrosis (N3), and infectednecrosis (N4), appears to be an easy and usefulguideline for the management of NP patients. Organfailures (72%) and mortality rate (36%) are higher whenthe process is infected. In the other groups, organicdysfunctions were frequent, but all the patients exceptone survived. The majority (80%) of patients were operated on. Only 20% of patients hadsuccessful nonsurgical treatment and they were in N3group. This percentage may increase through amorphological approach to treating necrosis, with theuse of endoscopic treatment for the disruption ofpancreatic duct, and better accuracy in the managementof patients with noninfected necrosis, whenever organfailures are present.