A CASE OF LAPAROSCOPIC CHOLECYSTECTOMY AFTER RETROPERITONEAL NECROSECTOMY FOR NECROTIZING PANCREATITIS

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 66; no. 1; pp. 169 - 172
• Main Authors: MIYAZAWA, Masatsugu, MUTO, Atsushi, ENDO, Hisahito, SATO, Masayuki, KOYAMA, Kaori, ASHINO, Yoshikazu
• Format: Journal Article
• Language: English
• Published: Japan Surgical Association 2005
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.66.169

Necrotizing pancreatitis often causes multiple organ failure in the early stage after the onset. In the latter stage, it is accompanied with infection of necrosis lesions in most cases. There is a limit of conservative treatment for infected pancreatic necrosis, and some surgical treatments are required. We report a case of laparoscopic cholecystectomy 14 months after retroperitoneal approach to necrotizing pancreatitis. A 48-year-old man complaining of abdominal pain after excessive drinking was referred to the hospital for treatment of acute pancreatitis in July, 2001. Although a temporary remission was achieved by conservative therapy, his symptoms became worse again. He was diagnosed as having necrotizing pancreatitis by abdominal CT scan, symptoms and positive materials in culture of percutaneous catheter drainage. Retroperitoneal necrosectomy and drainage were performed 95 days after the onset of the disease. The patient's postoperative course was uneventful, and he was discharged from the hospital on the 144th postoperative day. Laparoscopic chyolecyctectomy was able to perform about 14 months after the surgery. We think that retroperitoneal approach is of great value in treating necrotizing pancreatitis, because it is capable of avoiding direct intraperitoneal operations and performing sequential laparoscopic cholecystectomy.