Primary Early Surgical Management of Pancreatic Ascites Complicating Chronic Pancreatitis-A Single Centre Experience

Somasekar, R.; Raju, Prabhakaran; Amudhan, A.; Gnanasekar, Murugaiyan; Kalyanashanmugam, Sivakumar; Senthilkumaran, G; Rajendran, Senthilkumar; Naganathbabu, Obla

doi:10.7860/jcdr/2018/29907.11176

Cited by 2 publications

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“…Patients with acute or chronic pancreatitis and pleural effusion, ascites, and/or other IPFs were included in the study. The diagnosis of a pancreatic fistula was made based on fluid amylase levels >1,000 IU/L and fluid albumin levels >3 g/dL [ 7 ]. Patients with liver cirrhosis, suspected or proven malignancies, pleural effusion, or ascites that may be associated with heart disease, renal disease, or tuberculosis were excluded.…”

Section: Methodsmentioning

confidence: 99%

“…However, ERCP and interventions are not feasible in many cases of IPFs as traditional conservative management has been associated with prolonged hospitalization, malnutrition, and septic complications. Early surgical intervention, on the other hand, has been shown to treat both the fistula and the primary disease quickly, hence reducing morbidity risks associated with prolonged hospitalization [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

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A Single-Center Experience of Internal Pancreatic Fistulas

Sankar¹,

Prakashen²,

Banu³

et al. 2022

Cureus

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BackgroundInternal pancreatic fistula (IPF) is a complex disease with different etiologies, varied clinical presentations, and multiple management options. Unlike postoperative pancreatic fistula, IPF lacks guidelines for classification and management. The rarity of the disease makes randomized control studies unlikely and difficult to formulate guidelines. This has resulted in different approaches to managing IPF. IPF associated with both acute and chronic pancreatitis is treated with a step-up approach. Chronic pancreatitis-associated IPF treated with the traditional step-up approach is associated with increased morbidity. Prolonged fasting, drainage of protein-rich pancreatic fluid, and extended hospital stay add to the morbidity. Early surgical intervention in patients with IPF associated with chronic pancreatitis can treat both the fistula and underlying disease processes simultaneously. This may contribute to reduced morbidity and hospital stay. MethodologyA retrospective observational study was conducted between June 2018 and May 2019. IPF patients with fluid amylase >1,000 IU/L and fluid albumin >3 g/dL were included in the study. ResultsIn total, 32 patients were included in the study. A total of 13 patients had acute pancreatitis and 19 were associated with chronic pancreatitis. Pseudocyst and walled-off pancreatic necrosis were present in 18 patients. The duration of treatment for the traditional group was 8-14 weeks, and for the early surgery group, it was 8-10 days. Patients were followed up for two years, and none of the patients in the early surgery group had a recurrence. ConclusionsThe overall mortality of IPF is low but it has high morbidity. The delay in treatment may contribute to high morbidity; hence, early surgical intervention may change the clinical course. The primary pathology of the pancreas can be addressed simultaneously as well. In our study, early surgical intervention was associated with lesser morbidity and decreased duration of hospital stay while recurrence rates and mortality were comparable to the traditional management protocol.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Single-Center Experience of Internal Pancreatic Fistulas

Sankar¹,

Prakashen²,

Banu³

et al. 2022

Cureus

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Study of Clinical Profile of Patients With Pancreatic Ascites

Revathy

Sumathi

et al. 2020

IJAR

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Background: Pancreatic diseases and their complications are common in the Indian Subcontinent. The exact prevalence of the pancreatic ascites is not known. Estimated prevalence is 3.5% in patients with chronic pancreatitis and 6%–14% in patients with pseudocyst. Aim: To study the clinical profile of patients with pancreatic ascitesand to identify the cause of patients with pancreatic ascites. Material and methods: Prospective, descriptive study. Consecutive patients with pancreatic ascites admitted between January 2018 and December 2019 were enrolled. Data retrieved included demographic, clinical profile and etiology of pancreatic ascites. Results:Total number of study subjects was 26, majority were males (25/26), with mean age of 36.8 years. Most common symptom was abdominal pain and abdominal distension in 18 patients (69 %).Majority of patients had chronic pancreatitis (88.7%). Alcohol is the most common etiology in 23 (88.7%) patients. Conclusion: The results of our study suggests that the majority of patients with pancreatic ascites were having chronic pancreatitis with pseudocyst and alcohol consumption as a leading cause.

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Primary Early Surgical Management of Pancreatic Ascites Complicating Chronic Pancreatitis-A Single Centre Experience

Cited by 2 publications

References 0 publications

A Single-Center Experience of Internal Pancreatic Fistulas

A Single-Center Experience of Internal Pancreatic Fistulas

Study of Clinical Profile of Patients With Pancreatic Ascites

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