The first complete general study of acute necrotizing hemorrhagic pan creatitis was made in 1889 by Reginald Fitz. If we survey the therapeutic evolution of this severe illness, we may briefly summarize it into three pe riods: (a) resolutely surgical treatment, from approximately 1880 to 1938; (b) much more conservative treatment, from 1938 to 1963; and (c) a return to surgery, from 1963 onward. Hoffmann, in 1911, was probably the first to advocate the removal of the necrotic portion of the pancreas. In 1933, Okinczyc wrote: "The ope rative indications are not a matter for discussion; emergency surgery must be quick to manage the patient's poor resistance." So: "go right to the target, expose, drain ... and hope!" Leriche and Arnaud, more inge nious, said: "The aim of the operation is to avoid diffusion of the pan creatic juice into the abdominal cavity and limit the harmful effects of what remains in situ ... " With the progress in intensive care techniques, the "conservatives" emphasizing the poor results of surgery had no difficulty in imposing their point of view. Subsequently, in 1963, a new period began with the first successful emergency pancreatoduodenectomy, performed by Watts. If nowadays surgery for the secondary stage of necrosis or abscesses is generally accepted, emergency surgery still remains questionable even if not systematically refused. Many surgeons perform it under three condi tions: the worsening of the patient's general state despite medical treat ment, a dubious diagnosis, and a biliary etiology.

Does Incompetence of the Sphincter of Oddi Exist? Can It Account for Certain Cases of Acute Pancreatitis?

Pancreatic Duct Reflux and Acute Pancreatitis
Can Pancreaticoduodenal Reflux Explain Acute Pancreatitis? Yes, in Some Cases
The Role of Biliary Millilithiasis in the Pathogenesis of Acute Pancreatitis
Hemodynamic and Metabolic Impairment in Acute Pancreatitis
Acute Pancreatitis Following Transduodenal Sphincterotomy
Discussion
Controversies in the Biological Diagnosis of Acute Pancreatitis
The Cause of Hypophosphatemia in Acute Pancreatitis
Fibronectin as a Prognostic Parameter in Patients Suffering from Pancreatogenic Shock
The P3 Index in Acute Pancreatitis
The Amylase to Creatinine Clearance Ratio
Interest of Measuring Plasmatic and Urinary Lipase Activity in Pancreatic Disorders
Ultrasonic Diagnosis of Acute Pancreatitis
Contribution of Computed Tomography in the Diagnosis of Severe Acute Pancreatitis
Possibilities and Limits of Sonography in Acute Pancreatitis
Computed Tomography and Clinical Severity of Acute Pancreatitis
Computed Tomography and Acute Pancreatitis
Computer Tomography and Prognostics of Acute Pancreatitis
Retrospective Value of Diagnostic Procedures in Acute Pancreatitis
Computed Tomography and Anatomical Comparisons in Acute Pancreatitis
Possibilities and Limits of Computed Tomography
Contribution of Computed Tomography in the Management of Acute Necrotizing Pancreatitis
Peritoneal Lavage for the Diagnosis and Prognosis of Acute Pancreatitis
What can be Expected of Laparoscopy in the Diagnosis of Acute Pancreatitis?
Objective Prognostic Evaluation of Patients with Acute Pancreatitis
Prognostic Signs in Acute Pancreatitis
Prognostic Value of Nystagmus in the Evolution of Acute Pancreatitis.-Pancreatic Necrosis and Acute Pancreatitis
Functional Cardiorespiratory Patterns in Acute Pancreatitis
Histopathology of Experimental Pancreatitis of Ductal Origin
Current Status of Diagnosis and Conservative Treatment of Acute Pancreatitis
Anatomopathological Findings in Acute Pancreatitis
Acute Necrotic Pancreatitis: Anatomosurgical Correlations and Therapeutic Deductions
Proteinase Inhibitors of Microbial Origin in the Treatment of Experimental Acute Haemorrhagic Pancreatitis
Relationship of Glucagon to Exocrine Pancreatic Secretion and Its Use in Acute Pancreatitis
Treatment of Acute Pancreatitis with Somatostatin. A Randomized Study
Trypsinogen and Trypsin in Acute Pancreatitis. Physiopathology
A Prospective Study to Determine the Efficacy of Dextran 40 in Acute Pancreatitis
Our Experience in the Treatment of Acute Necrotizing Hemorrhagic Pancreatitis
Acute Pancreatitis: Results of 42 Observations
Acute Pancreatitis. Retrospective Study of 225 Cases
Points of View on Necrosis in Acute Pancreatitis
Peritoneal Lavage in Acute Pancreatitis
Our Experience with Drainage-Lavage of the Peritoneal Cavity
A Controlled Randomized Study on the Value of Peritoneal Lavage in Acute Pancreatitis (an Interim Report)
Therapeutic Peritoneal Lavage
Peritoneal Dialysis in Acute Necrotic-Hemorrhagic Pancreatitis
Acute Hemorrhagic-Necrotic Pancreatitis: Laparotomy or Peritoneal Lavage? Results of a Randomized Controlled Clinical Study
Controversies in Acute Pancreatitis
Endoscopic Papillotomy as a Therapeutic Alternative in Acute Biliary Pancreatitis
Endoscopic Sphincterotomy in Acute Biliary Pancreatitis
Endoscopic Sphincterotomy in Acute Pancreatitis
Possibilities and Limits of Intensive Care in Acute Necrotic Pancreatitis
Controversies in Possibilities and Limits of Intensive Care. Conclusions
Acute Pancreatitis: Controversial Operative Indications
Our Criteria for Surgical Intervention in Acute Necrotizing Pancreatitis
Controversies in Surgical Indications
Results of Exeresis in Acute Necrotico-hemorrhagic Pancreatitis
Choice of Treatment in Acute Pancreatitis
Surgical Treatment of Acute Necrotizing Pancreatitis: A Series of 30 Cases
Surgical Treatment of Acute Necrotizing Hemorrhagic Pancreatitis: A Series of 46 Cases
Acute Pancreatitis: Conservative Attitude, Expectant Vigilance
Acute Pancreatitis: Results and Strategy of Operative Treatment
Role of Total Pancreatectomy in the Treatment of Acute Necrotizing Pancreatitis. Indications and Results of 22 Cases
Early and Iterative Interventions in Cases of Acute Necrotizing Pancreatitis: An Answer to the Absence of Correlation Between Their Anatomical and Clinical Expressions
Enteral Nutrition by Alimentation Jejunostomy in 11 Cases of Severe Acute Pancreatitis
The Role of Artificial Nutrition in the Treatment of Acute Pancreatitis
Role of Complete Parenteral Treatment Nutrition in Acute Pancreatitis
Amino Acid Metabolism in Acute Necrotizing Pancreatitis. Aspects of Parenteral Nutrition
Secondary Colonic Lesions in Acute Pancreatitis
Necrotizing Colitis and Acute Necrotizing Pancreatitis. Report of Eight Cases. Role of Shock
Problems in the Management of Pancreatic Abscesses
Treatment of Pancreatic Abscess
Treatment of Fistulas Following Laparotomy for Acute Pancreatitis
General Conclusions and Adoption of a Diagnostic and Therapeutic Programme for the Future.