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David W. Rattner, MD
Boston, Mass

Arch Surg. 2000;135:141.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Oria et al nicely describe the essential elements for successful internal drainage of giant acute pancreatic pseudocysts: removal of necrotic tissue from the pseudocyst cavity and establishment of dependent drainage. It is presumably due to the lack of dependent drainage of the pseudocyst cavity that the complication rate following cystgastrostomy is as high as 50% in these patients.¹ Even when dependent drainage is established, the failure to debride necrotic material in conjunction with an enteric communication can lead to life-threatening retroperitoneal sepsis as was experienced by the authors prior to their introduction of video-assisted debridement. Oria et al allude to the Atlanta International Symposium classification system for acute pancreatitis² that attempts to provide a rational terminology for the protean morphologic manifestations of acute pancreatitis. While the definitions adopted by the Atlanta International Symposium are helpful for descriptive purposes, in reality the surgeon is faced with a . . . [Full Text of this Article]

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Internal Drainage of Giant Acute Pseudocysts: The Role of Video-Assisted Pancreatic Necrosectomy
Alejandro Oría, Carlos Ocampo, Hugo Zandalazini, Luis Chiappetta, and Carlos Morán
Arch Surg. 2000;135(2):136-140.
ABSTRACT | FULL TEXT