Peritonitis
Peritonitis and intra-abdominal infection are not synonymous. The former can mean sterile inflammation of the peritoneum as the chemical peritonitis seen following an early perforation of a peptic ulcer or acute pancreatitis. The latter implies inflammation of the peritoneum caused by microorganisms. Initially we developed STAR to treat only advanced, deteriorating cases of peritonitis. STAR reduced mortality of severe intra-abdominal infection significantly by 30% to 50%...

Dead Bowel
Patients with dead bowel benefit from STAR because it is difficult to assess extend and progression of bowel ischemia at the time of the initial laparotomy. With STAR dead bowel can be stapled off at the index STAR and anastomoses may be deferred to subsequent STAR entries and sutured once optimal perfusion to the bowl stumps is certain...

Diverticulitis
Diverticulitis is a common complication of diverticula and associated with life threatening complications. While hemorrhage is rarely an indication for surgical intervention a perforation may require both emergency and elective operative management. Perforation may induce a local intra-abdominal abscess or diffuse peritonitis when host defenses cannot confine the infection locally. A separate, more severe form of peritonitis may arise when a diverticular abscess perforates...

Infected Pancreatic Necrosis
Although pancreatitis can often be cured medically, infection progressing to infected pancreatic necroses continue to require surgical intervention. STAR is helpful in theses case to gently remove pancreatic necroses and do effective source control...

Transplant Pancreatitis
Infection after pancreas transplant was associated with almost 100% mortality until we started treating these patients with STAR. More STAR entries are usually required and the interval between STAR entries can be extended to 48 hours because wound healing processes are suppressed buy immuno-suppressive medication...