[Treatment of intra-abdominal sepsis and necrotizing pancreatitis with staged lavage using a Zipper].

The mortality of generalised intra-abdominal sepsis and severe necrotising pancreatitis remains very high. The persistence of intra-abdominal septic foci leads to recurrent abscess formation, persistence of sepsis and development of multiple organ failure, ultimately leading to the death of the patient. Therefore we believe that a repeated and total elimination of all septic and necrotic material is the cornerstone of an adequate surgical therapy in these patients. We performed "staged lavage" with the aid of a Zipper in 24 patients (10 with intra-abdominal sepsis and 14 with severe necrotising pancreatitis). Via the Zipper 98 relaparotomies were performed (mean 4.1 per patient). The high Apache II-scores (12 to 45, mean 24) illustrate the severity of disease in most of these patients. The expected in-hospital mortality-rate was 59% while in our series 7 patients died on a total of 24 (28%).