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ACUTE PANCREATITIS ASSOCIATED WITH NECROSIS AND PERFORATION OF THE COMMON BILE DUCT

JERRY ZASLOW, M.D.
AMA Arch Surg. 1953;67(1):47-51. doi:10.1001/archsurg.1953.01260040050007.
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NOT TOO many years ago it was generally felt that when a diagnosis of acute pancreatitis was suspected, the patient should undergo exploration; if pancreatitis was found, the pancreatic area and the biliary tract were drained. The mortality figures with this form of management were high. When a laboratory procedure for diagnosing acute pancreatitis was devised and found to be reliable, the management of patients with this disease was modified. In most clinics today it is felt that when the diagnosis of acute pancreatitis is made on the basis of elevated serum amylase and/or lipase levels, nonoperative treatment is indicated, except in certain circumstances.1

Bockus, Roth, and Sifre1a state that the only indications for operation are either "when other acute abdominal emergencies cannot be excluded or if the pancreatitis becomes complicated by suppuration, severe hemorrhage or spreading peritonitis." On the other hand, Rhoads, Howard, and Moss2 take

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