Decompressive laparotomy has been shown to effec-
tively reduce IAP and reverse the symptoms typically
associated with ACS [32]. In patients with severe acute
pancreatitis and IAH, intra-abdominal ?uid collections
may not always be present and therefore decompres-
sive laparotomy and temporary abdominal closure is
the most effective way of decreasing IAP [7, 15, 33].
The most common approach to decompressive
laparotomy is through a long, vertical midline incision,
but a transverse incision to anticipate later pancreatic
surgery may also be used. Because of the risk of