Objective: The study evaluated efficiency of percutaneous drainage in the therapy of severe acute pancreatitis with multi-organ failure. Material and methods: In the period of 1998–2000 the authors examined 441 patients with the diagnosis of acute pancreatitis. The diagnosis of severe acute pancreatitis was established in 115 patients (27%), 55 of them treated with drainage only (47.8% of the subset), 34 patients (29.6% of the subset) with drainage and surgery, and 26 patients (22.6% of the subset) were treated conservatively. Eighteen patients suffered from multi-organ failure, 26 patients had septic temperature. They were inserted drain, either 18 G pig tail (Optimed) or 20–26 G Mallecot (Boston Scientific). The successradiologie the patients with acute pancreatitis were treated. There were 115 questionnaires on the whole. Results: Fifty one of the 115 forwarded questionnaires (44.3%) returned. Thirty nine of them (76.4%) evaluated drainage as a method which improved the health state of the patient. Twelve of the interviewed physicians (23.4%) declared that the health state of the patients had not improved or actually deteriorated. Five patients (9.8%) died, two of them from bleeding, one from ictus, one from septic state and one from respiratory insufficiency. Twelve patients (66.6%) out of 18 with multi-organ failure were drained and operated on, and six patients (33.4%) were drained only. Three patients out of these 18 subjects (16%) died from bleeding and respiratory insufficiency, all of them belonging to the group of 12 patients who had been operated on and drained. The drainage in these patients was performed when the necrotic solid matter was without sings of becoming liquefied. A marked improvement was noted in 12 patients, deterioration in three patients. Twenty six patients suffered from septic temperature, five of them were operated on and drained, the other subjects were drained only. Conclusion: Percutaneous drainage of severe acute pancreatitis was evaluated by interviewing the surgeons and anesthesiologists, whether this technique improved the health state of the patients. The method proved to be safe and successful in the therapy of severe acute pancreatitis and in patients with multi-organ failure who had necrotic solid matter.

        Key words: severe acute pancreatitis – multi-organ failure – infected necrosis – abscess of the pancreas – percutaneous catheter drainage