Peritoneal lavage in severe acute pancreatitis.

An analysis is presented of 73 attacks of acute pancreatitis treated with non-operative peritoneal lavage, classified according to Ranson's 11 signs and followed up for on average four years. None of the 21 moderate attacks was associated with complications or mortality. In the 52 severe attacks, four patients (7.7%) died, new pseudocyst developed in five patients (9.6%) and abscess in four (7.7%), and diabetes was found in 12 patients (23%) at follow-up. In all these respects the severe attacks showed statistically significant difference from the moderate attacks, as did the need for assisted ventilation, the volume of gastric retention and the length of hospital stay. The authors conclude that non-operative peritoneal lavage is beneficial, probably by removing toxic substances from the peritoneal cavity.