Synchronous anterior celiotomy and posterior drainage of pancreatic abscess
T. V. Berne and A. J. Donovan
Pancreatic abscess has been characterized by a high rate of reoperation for
persistent sepsis and by a high mortality. Nine patients with pancreatic
abscess have undergone synchronous anterior celiotomy and posterior
drainage following resection of the 12th rib. Pancreatic abscess was
secondary to acute pancreatitis in seven of the cases. In two cases, the
combined procedure was a secondary operation to treat abscess that
developed following surgery for pancreatic trauma. All of these nine
patients survived. One patient required reoperation for drainage of a left
retrocolic abscess. A synchronous approach permits adequate exploration of
the abdomen, provides the exposure necessary to remove necrotic tissue, and
allows dependent drainage of the left subphrenic space without fear of
splenic, pancreatic, or vascular injury.
