Comparison of pancreatic function and quality of life between patients with infected pancreatitis necrosis undergoing open necrosectomy and minimally invasive drainage: A long‑term study

Abstract

The present study aimed to determine whether a difference in pancreatic function and quality of life (QoL) is present between patients with infected pancreatitis necrosis (IPN) undergoing open necrosectomy (ON) and minimally invasive drainage (MID). The medical records of patients with IPN discharged from Jinling Hospital were retrospectively analyzed. Pancreatic function and QoL were compared between patients treated with ON and MID. Pancreatic endocrine and exocrine function were assessed using the oral glucose tolerance test and fecal elastase-1 (FE-1) test, respectively. The standard Short Form 36 health questionnaire was used to evaluate the QoL of patients. The analysis included 101 patients who underwent either ON (n=40, 39.6%) or MID (n=61, 60.4%). There were no significant differences in exocrine and endocrine pancreatic function between the two groups evaluated based on FE-1, fasting blood glucose, glycated hemoglobin and 2-h plasma glucose (P<0.05). The scores of the QoL questionnaire were significantly higher in patients treated with MID than in patients treated with ON, including the scores of general health perception (19.39±3.07 vs. 17.37±3.63, P=0.003), vitality (18.93±2.88 vs. 17.57±3.47, P=0.035), social role functioning (8.85±1.43 vs. 8.15±1.98, P=0.042), emotional role functioning (5.33±1.07 vs. 4.82±1.25, P=0.034), mental health (24.21±3.31 vs. 22.57±3.91, P=0.026) and the total QoL score (125.12±13.16 vs. 116.50±16.94, P=0.005). In conclusion, although the initial health of the patient may have influenced the treatment provided, patients with IPN who received MID achieved a better post-treatment QoL than those treated with ON. No significant differences between the two groups were observed regarding the endocrine and exocrine functions of the pancreas.

Quality of life after surgical and endoscopic management of severe acute pancreatitis: A systematic review

“…Overall, eleven studies were included of which most were from European centres ( n = 7)[ 17 , 27 - 32 ]. Three studies were conducted in American centres[ 11 , 16 , 33 ] and one in Asia[ 34 ]. The studies were undertaken between 1993 and 2020 including an overall number of 756 patients.…”

“…The studies were undertaken between 1993 and 2020 including an overall number of 756 patients. Three studies were randomized trials[ 11 , 28 , 30 ], four were prospective cohort studies[ 17 , 29 , 31 , 32 ], and four were retrospective cohort studies with prospective follow-up[ 16 , 27 , 33 , 34 ]. Only four studies compared surgical intervention to endoscopic intervention[ 11 , 27 , 28 , 34 ], while five studies investigated surgical approaches[ 16 , 17 , 29 , 30 , 32 ], and one study investigated endoscopic intervention alone[ 33 ].…”

“…Three studies were randomized trials[ 11 , 28 , 30 ], four were prospective cohort studies[ 17 , 29 , 31 , 32 ], and four were retrospective cohort studies with prospective follow-up[ 16 , 27 , 33 , 34 ]. Only four studies compared surgical intervention to endoscopic intervention[ 11 , 27 , 28 , 34 ], while five studies investigated surgical approaches[ 16 , 17 , 29 , 30 , 32 ], and one study investigated endoscopic intervention alone[ 33 ]. Most studies were of cohorts with confirmed or suspected infected pancreatic or peripancreatic necrosis requiring intervention.…”

“…Four studies compared HR-QoL between patients who underwent endoscopic and surgical interventions of which two were randomized trials[ 11 , 28 ] and two were retrospective cohorts[ 27 , 34 ]. In Bang et al [ 11 ]’s randomized trial 34 patients underwent endoscopic necrosectomy and 32 patients underwent minimally invasive surgical necrosectomy for necrotizing pancreatitis.…”

Management of pancreatic walled-off necrosis using an ultrasonic pneumatic lithotripsy system and double-catheter aspirated lavage performed through drainage tract: a case report

“…During the past two decades, cases of IPN treated by alternative MIAs have not usually required conventional open necrosectomy. 4 –8, 10 Common MIAs include percutaneous radiological drainage, a transgastric approach, a transperitoneal approach, and a retroperitoneal approach. 11 –13 Retroperitoneal necrosectomy is an approach that has risen to favor in this regard, especially for patients with lateral necrosis.…”