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Mary C. McCarthy, MD; Richard M. Dickerman, MD

Arch Surg. 1982;117(4):476-480.

Abstract
• The substantial morbidity and mortality associated with severe acute pancreatitis has led to a variety of therapeutic approaches. We reviewed the records of 40 patients who had undergone the "triple-tube" procedure (gastrostomy, cholecystostomy, and jejunostomy) with drainage of the lesser sac and retroperitoneum. Cardiovascular, respiratory, renal, and hepatic dysfunction were common, and reoperation was required in 35% (14) of the cases. Gastrostomies and jejunostomies were associated with numerous complications, and cholecystostomies were rarely of benefit except when biliary tract disease was present. Debridement and drainage of necrotic pancreatic and retroperitoneal tissue afforded a higher survival rate in the small population in which they were employed. The overall mortality was 55% (22), reflecting the severity of the disease at the time of surgery. Early recognition and limited surgical debridement may be beneficial in this high-risk group.

(Arch Surg 1982;117:476-480)

Author Affiliations
From the Department of Surgery, University of Texas Health Science Center, Dallas (Dr McCarthy), and the Department of Surgery, Methodist Hospitals of Dallas (Dr Dickerman).

Footnotes
Accepted for publication Oct 5, 1981.

Read before the annual meeting of the Pancreas Club, Salt Lake City, May 18, 1980.

Reprint requests to Department of Surgery, Methodist Hospitals of Dallas, PO Box 225999, Dallas, TX 75265 (Dr Dickerman).

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