Long-term outcome of necrotizing pancreatitis treated by necrosectomy

Tsiotos, Gregory G.; León, Enrique Luque-de; Sarr, Michael G.

doi:10.1046/j.1365-2168.1998.00950.x

Cited by 155 publications

(85 citation statements)

References 19 publications

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“…Buscher et al, found increased basal level of c-peptide in patients undergoing conservative management of acute necrotizing pancreatitis [13]. Similar findings were also obtained by Tsiotos et al, after acute pancreatitis [14]. The difference in findings might well be attributable to the complex equilibrium between the amount of beta cell loss leading to decrease in serum c-peptide level versus the development of secondary diabetes due to peripheral insulin resistance and consequent increase in serum c-peptide level.…”

Section: ) Hb1acmentioning

confidence: 54%

Outcome following Necrotizing Pancreatitis

2017

IJSR

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Objective: To study the long term outcome following recovery from acute necrotizing pancreatitis in terms of structural and functional status of pancreas (both exocrine and endocrine) and to study the correlation, if any, of the long-term consequences with respect to the severity of necrotizing pancreatitis and between the groups of patients managed conservatively and operatively. Methods: All patients with a diagnosis of acute necrotizing pancreatitis based on Balthazar CT severity index (CTSI) in AIIMS, New Delhi following recovery of the illness were included in the study between the period from March, 2011 to June, 2012. Patients managed both operatively and nonoperatively were followed up at six months and at one year. Structural changes were assessed by ultrasound at 6 months and 1 year. CECT scan/ MRI with MRCP/ ERCP/ EUS were done if ultrasound reveals any abnormality. Exocrine function of pancreas was assessed by fecal fat and stool elastase and endocrine function by fasting blood sugar, fasting serum c-peptide and HbA1c levels. Results: Pancreatic atrophy was more in the operated patients compared to nonoperated patients at discharge and at 6 months of follow up. Pancreatic exocrine and endocrine insufficiency, were similar in both groups. Conclusion: There was a high correlation between extent of necrosis and subsequent development of pancreatic atrophy and diabetes in both groups of patients. Exocrine and endocrine functions deteriorate after necrotizing pancreatitis irrespective of conservative or operative treatment and there is no statistically significant difference between the two modes of treatment.

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Section: ) Hb1acmentioning

confidence: 54%

Outcome following Necrotizing Pancreatitis

2017

IJSR

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“…Some predictive factors, such as the CT computed tomography, RCT randomized controlled trial, NR not reported, CTSI CT Severity Index, Ranson severity score for acute pancreatitis, APACHE acute physiology and chronic health evaluation APACHE II scores, CT scores, and organ failure, can be used to evacuate the condition of a patient and might influence mortality or clinical success rates. However, many studies deemed that the CTSI scores did not show a good correlation with patient outcome [7,16,28]. Guillaume Baudin considered that CT scores did not appear to influence mortality or clinical success rates [32].…”

Section: Discussionmentioning

confidence: 99%

“…However, such aggressive treatment is associated with significant complications and mortality in 11-39 % of patients [5][6][7]. In this context, traditional open necrosectomy gradually Lichi Ke and Junhua Li contributed equally to this work.…”

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Percutaneous Catheter Drainage in Infected Pancreatitis Necrosis: a Systematic Review

et al. 2016

Indian J Surg

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The primary aim of this study was to present the outcomes of percutaneous catheter drainage (PCD) in patients with infected pancreatitis necrosis. A second aim was to focus on disease severity, catheter size, and additional surgical intervention. A literature search of the PubMed/MEDLINE/Cochrane Library (January 1998 to February 2015) databases was conducted. All randomized, non-randomized, and retrospective studies with data on PCD techniques and outcomes in patients with infected pancreatitis necrosis were included. Studies that reported data on PCD along with other interventions without the possibility to discriminate results specific to PCD were excluded. The main outcomes were mortality, major complications, and definitive successful treatment with percutaneous catheter drainage alone. Fifteen studies of 577 patients were included. There was only one randomized, controlled trial, and most others were retrospective case series. Organ failure before PCD occurred in 55.3 % of patients. With PCD alone, definitive successful treatment was 56.2 % of patients. Additional surgical intervention was required after PCD in 38.5 % of patients. The overall mortality rate was 18 % (104 of 577 patients). Complications occurred in 25

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“…Although the presence of abdominal compartment syndrome is usually treated with a decompressive laparotomy, 2 advocating the same in acute pancreatitis would run contrary to the dogma that operations early in acute pancreatitis are associated with an increase in morbidity and mortality. 3,4 The study purports to judge the efficacy of IAP and APP early in the onset of the disease as predictors of outcome. The authors agree that infection is a significant contributor to mortality after the early phase of the disease, 5,6 but there is no evidence to indicate that this can be adequately detected 72 h after admission.…”

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confidence: 99%