Pancreatic Necrosectomy

Preoperative
Main indication is infected pancreatic necrosis. Check CT scans. Ideal time to operate is 3+ weeks post onset of acute pancreatitis where viable and non viable pancreas has demarcated.

Equipment
Omnitract or Book-Walter fixed retractor system. Suction irrigator
Empty sponge forceps

Incision
Midline upper abdominal incision extending just below the umbilicus. A roof top incision can also be used. Review the CT scans to determine where the necrosis extends to.

Approach
Note where collection is bulging. Check positon using a 19G needle to confirm in the right spot.