Analysis of the delayed approach to the management of infected pancreatic necrosis

Nilesh Doctor, Sujith Philip, Vidhyachandra Gandhi, Maharra Hussain, Savio G. Barreto

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)

Abstract

AIM: To analyze outcomes of delayed single-stage necrosectomy after early conservative management of patients with infected pancreatic necrosis (IPN) associated with severe acute pancreatitis (SAP). METHODS: Between January 1998 and December 2009, data from patients with SAP who developed IPN and were managed by pancreatic necrosectomy were analyzed. RESULTS: Fifty-nine of 61 pancreatic necrosectomies were performed by open surgery and 2 laparoscopically. In 55 patients, single-stage necrosectomy could be performed (90.2%). Patients underwent surgery at a median of 29 d (range 13-46 d) after diagnosis of acute pancreatitis. Sepsis and multiple organ failure accounted for the 9.8% mortality rate. Pancreatic fstulae (50.8%) predominantly accounted for the morbidity. The median hospital stay was 23 d, and the median interval for return to regular activities was 110 d. CONCLUSION: This series supports the concept of delayed single-stage open pancreatic necrosectomy for IPN. Advances in critical care, antibiotics and interventional radiology have played complementary role in improving the outcomes.

Original languageEnglish
Pages (from-to)366-371
Number of pages6
JournalWorld journal of gastroenterology
Volume17
Issue number3
DOIs
Publication statusPublished - 21 Jan 2011
Externally publishedYes

Keywords

  • Infected necrosis
  • Inflammation
  • Necrosectomy
  • Pancreas
  • Severe acute pancreatitis

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