Symposium on pancreatitis: 2. Surgical management of acute pancreatitis.

While there is general agreement on the indications for surgery in acute pancreatitis, the preferred operation is controversial and the approach ranges from one that is very conservative to one that is extremely aggressive. The author believes that in all cases the gallbladder should be opened to permit exploration and that cholangiography should be performed. If gallstones are discovered they should be removed and the organ drained; cholecystectomy is advised if the procedure is at all feasible. In a personal series of 50 cases of acute pancreatitis, 10 patients had early operation and 19 surgical procedures were performed.