The role of surgery in acute pancreatitis.

Due to the lack of randomized controlled studies comparing medical with surgical therapy, the role of surgery in acute pancreatitis is not clear. This is especially true in critically ill patients who are rapidly deteriorating with hemorrhagic or necrotizing pancreatitis. Surgical intervention may be of benefit in those patients who do not have a clearcut diagnosis of pancreatitis and may have a surgically correctable disorder, who have biliary or pancreatic duct disease, or who have developed a complication such as abscesses or a pseudocyst. The mortality rate of performing a laparotomy on patients with acute pancreatitis is not prohibitive.