Severe pancreatitis--still a frequently mortal illness.

The treatment of severe pancreatitis remains a challenge. Eighty-six cases were retrospectively reviewed after treatment in intensive care units at two major Brisbane Hospitals between January 1980 and May 1986. Thirty-three patients died. Sixty-one patients had 97 operations, with 40% mortality. The severity of biliary and postoperative pancreatitis is highlighted. After early detection and aggressive resuscitation of severe cases, repeated debridement of necrotic pancreas and retroperitoneal slough may offer the best treatment. Marsupialization is an effective method of controlling sepsis after necrosectomy and abscess drainage.