Outcome of Acute Pancreatic and Peripancreatic Collections Occurring in Patients With Acute Pancreatitis

Manrai, Manish; Kochhar, Rakesh; Gupta, Vikas; Yadav, Thakur Deen; Dhaka, Narendra; Kalra, Naveen; Sinha, Saroj Kant; Khandelwal, Niranjan

doi:10.1097/sla.0000000000002065

Cited by 92 publications

(72 citation statements)

References 38 publications

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“…This study is a retrospective analysis of prospectively collected data comparing the various outcome parameters of the two main etiologies of AP, namely, GS and alcohol. These two etiologies account for 70-80% of all AP, 5,6,15 as was also the case in the current study where 80.1% of the patients either had GS or alcohol as the etiology. The etiologies of alcohol-and GS-related AP have a clear gender bias as has been established in previous multiple studies, with males having a higher percentage of alcoholrelated AP and females a higher percentage of GS-related AP.…”

Section: Discussionsupporting

confidence: 82%

“…4 Although various etiologies have been described to cause AP, the two most common etiologies accounting for 70-80% of all the cases are gallstones (GSs) and alcohol. 5,6 Identification of the etiology may help in the better formulation of treatment strategies or prevention of recurrence, although the pattern of conservative management of the ongoing attack of AP is similar across etiologies. Whether etiology contributes to the outcome in patients with AP is an unresolved issue.…”

Section: Introductionmentioning

confidence: 99%

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Comparative study of the outcome between alcohol and gallstone pancreatitis in a high‐volume tertiary care center

et al. 2019

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Background and Aim The two most common etiologies of acute pancreatitis (AP) are alcohol and gallstone. Whether etiology contributes to the outcome in patients with AP is an unresolved issue, more so in the severe form of the disease. The aim is to study the effects of the etiological factors of alcohol and gallstone on the disease course and the role of etiology in the subgroup of severe AP. Methods Consecutive patients of AP with alcohol or gallstone etiology were included. Various severity parameters and various outcome measures, such as need for organ support, intensive care, surgical or radiological intervention, hospital stay, and mortality, were evaluated between the two groups. Results Of the 759 patients, alcoholic pancreatitis was seen in 368 (48.5%), while gallstone disease was observed in 246 (32.4%). Gallstone pancreatitis occurred in older age ( P < 0.0001), had a higher female predilection ( P < 0.001), and a higher body mass index ( P = 0.002) compared to alcohol pancreatitis. Both groups were similar in terms of development of various organ failures and various severity assessment scores. Alcoholic AP had higher rates of necrosis ( P = 0.05) and the need for percutaneous catheter drainage ( P = 0.02). Outcome measures such as length of hospital stay, need for intensive care, organ support, surgical intervention, or mortality were similar between the two groups. Subset analysis of severe AP (303 patients) showed no difference between the two etiologies with regard to outcome. Conclusion The outcome of AP was independent of the etiology of the disease, alcohol or gallstone, and more so in the severe form of the disease. The number of local complications tends to be slightly higher in the alcoholic group.

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Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Comparative study of the outcome between alcohol and gallstone pancreatitis in a high‐volume tertiary care center

et al. 2019

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“…reported that patients with AIP had a higher intervention rate than those with EXPN. Their PCD rate was otherwise also higher than reported in other long‐term follow‐up studies of AIP . Our results suggests that patients with EXPN alone have a more severe clinical course and require more aggressive management compared to those with AIP.…”

Section: Discussioncontrasting

confidence: 46%

Impact of the site of necrosis on outcome of acute pancreatitis

et al. 2018

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ObjecivesTo compare the clinical outcome of patients with extrapancreatic necrosis (EXPN) alone with that of acute interstitial pancreatitis (AIP), pancreatic parenchymal necrosis (PPN) alone, and combined PPN and EXPN.BackgroundThere are only a few studies in the literature in which EXPN has been recently recognized as a subtype of acute necrotizing pancreatitis (ANP), with a better prognosis.MethodsWe analyzed clinical data and outcome variables of 411 consecutive acute pancreatitis (AP) patients between January 2012 and December 2014. Contrast‐enhanced computed tomography (CECT) images of each patient were reviewed and characterized as AIP or ANP. Patients with ANP were divided into EXPN alone, PPN alone, and combined PPN and EXPN. Outcome variables were then compared between these groups.ResultsOf the 411 patients, 74 (18%) had AIP, and 337 (82%) had ANP. Patients with EXPN alone (n = 40; 11.8%) had similar outcomes as patients with PPN alone (n = 12; 3.5%); however, their outcome was worse than that of patients with AIP, with a higher frequency of persistent organ failure (POF), need for percutaneous catheter drainage (PCD), and longer length of hospitalization (LOH). Patients with combined PPN and EXPN (n = 285; 84.7%) had the worst clinical course, with higher frequency of POF, infected necrosis, intervention requirement, and longer LOH.ConclusionPatients with combined PPN and EXPN have a severe disease course with the worst clinical outcomes; patients with AIP patients have the most benign course, while patients with EXPN alone stand between the two extremes of disease course with an intermediate grade of severity.

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“…1 The rising incidence and severity of AP probably reflects rising incidence of obesity in children and increasing awareness among pediatricians. 5 However, about 40% of pseudocysts develop symptoms requiring drainage. Complications in the delayed phase (>4 weeks) of AP include infection and development of pancreatic fluid collections (PFC).…”

Section: Introductionmentioning

confidence: 99%

“…Acute fluid collections (<4 weeks old) are usually asymptomatic and most resolve spontaneously. 5 However, about 40% of pseudocysts develop symptoms requiring drainage. 6 Drainage of PFC can be achieved by endoscopic, percutaneous or surgical methods.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic drainage of pancreatic fluid collections: Long‐term outcomes in children

Nabi

Lakhtakia

Basha

et al. 2017

Digestive Endoscopy

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Outcome of Acute Pancreatic and Peripancreatic Collections Occurring in Patients With Acute Pancreatitis

Cited by 92 publications

References 38 publications

Comparative study of the outcome between alcohol and gallstone pancreatitis in a high‐volume tertiary care center

Comparative study of the outcome between alcohol and gallstone pancreatitis in a high‐volume tertiary care center

Impact of the site of necrosis on outcome of acute pancreatitis

Endoscopic drainage of pancreatic fluid collections: Long‐term outcomes in children

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