Median upper abdominal laparotomy with left-sided incision around the navel. After opening the peritoneum, hemorrhagic ascites are released. Upon insertion of the abdominal wall retractor, abundant blood clots are visible in the left upper abdomen.
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Opening of the Abdominal Cavity
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Exploration and Debridement of Necrosis
Soundsettings First, aspiration of the ascites and removal of the clots. This reveals liquefied necrosis of the pancreas and the peripancreatic tissue. There has been digestion and breakthrough of the gastrocolic ligament in the area of the gastric corpus. After taking a swab, the necrosis is debrided and an extensive lavage is performed.
Note:
Since necrotizing pancreatitis usually represents a "superficial" necrosis of the organ and central parts of the pancreas are mostly vital, considerable experience may be necessary to perform the procedure comprehensively without inducing bleeding or resecting functional tissue.
Complete Opening of the Omental Bursa; Cholecystectomy
The omental bursa is completely opened by transecting the remaining gastrocolic ligament between Ov
The omental bursa is completely opened by transecting the remaining gastrocolic ligament between Ov
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