Original article / research
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Year :2021
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Month :
July
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Volume :
10
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Issue :
3
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Page :
SO34 - SO38
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Necrotising Pancreatitis- A Cross-sectional Study on Surgical Outcomes of Pancreatic Necrosectomy
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BM Satish Kumar, R Santhosh, P Nagaraj
1. Assistant Professor, Department of Surgical Gastroenterology, KLES Dr. Prabhakar Kore Hospital and MRC, Belgaum, Karnataka, India.
2. Assistant Professor, Department of Surgical Gastroenterology, Malabar Medical College Hospital, Kozhikode, Kerala, India.
3. Senior Consultant, Department of Surgical Gastroenterology, Manipal Hospitals, Bengaluru, Karnataka, India.
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Correspondence Address :
BM Satish Kumar, R Santhosh, P Nagaraj,
R Santhosh,
Department of Surgical Gastroenterology and HPB Surgery, Division of Gastro Sciences, Malabar Medical College, Modakkallur, Atholi Post, Kozhikode, Kerala, India.
E-mail: drsanthoshr@ymail.com
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| | | ABSTRACT |  |
: Introduction: Necrotising Pancreatitis (NP) is the severe form of acute pancreatitis accounting for significant mortality (15- 40%), morbidity (~25%) and has significant health costs. The traditional management of infected necrosis has centered on open surgical debridement which is accompanied by significant risk of stress, organ failure and complications. Short-term and long-term functional outcomes after operative treatment of NP have not been studied extensively.
Aim: To evaluate the short-term and long-term surgical outcomes in patients undergoing surgery for NP.
Materials and Methods: This was a cross-sectional study of patients who underwent surgery for NP conducted at Manipal Hospital, Bangalore between June 2009 to March 2016. The electronic records pertaining to such patients were retrieved. Various surgeries done were grouped. Surgical complications and short-term outcomes like new onset organ failure, Surgical Site Infection (SSIs), haemorrhage, bowel fistula, re-explorations, and requirement of additional procedures, hospital stay and the mortality were studied by hospital data. Long-term outcomes like endocrine/ exocrine insufficiency, weight loss, recurrent pancreatitis, incision hernia were studied by prospective data collected from telephonic interview; questionnaires in addition to data collected as and when patient gets admitted and in Outpatient Department (OPD) during follow-up. A comparison with different surgical techniques like laparoscopy, open necrosectomy, Video assisted necrosectomy was made. Statistical analyses were performed by STATA 11.2 (College Station TX USA). Mann-Whitney test were used to find the significance difference between the length of stay and Intensive Care Unit (ICU) stay with the groups and it is expressed as mean and standard deviation, Chi-square test has been used to measure the association between different clinical variables. p<0.05 was considered as statistically significance.
Results: Forty six patients underwent surgical treatment during the study period. Patients' age ranged from 25 to 75 years (median age-44 years). Median postoperative ICU stay was 12 days (range of 01-32 days). The mean follow-up was 3.5 years. The overall mortality rate was 26% (12 patients). The mortality rates between laparatomy (33%) and minimally invasive necrosectomy (23%) groups were not significantly different (p=0.436). Secondary diabetes mellitus was observed in 18 (40%) and exocrine insufficiency in 8 (18%) of patients. The other long-term complications were recurrent pancreatitis in 7 (15%), biliary stricture 3 (6%) and incisional hernia in 3 (6%).
Conclusion: Mortality rate, organ failure rates and median ICU admission rate were similar across all surgical techniques though there was a trend of overall reduced complication rate. A long-term and close follow-up is advised in these patients for the late complications to be identified and treated.
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Keywords :
Laparoscopic, Long-term outcomes, Open necrosectomy,
Short-term outcomes, Video assisted retroperitoneal debridement
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DOI and Others :
10.7860/IJARS/2021/48277:2681
Date of Submission: Jan 01, 2021
Date of Peer Review: Feb 15, 2021
Date of Acceptance: Apr 05, 2021
Date of Publishing: Jul 01, 2021
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? NA
• For any images presented appropriate consent has been obtained from the subjects. NA
PLAGIARISM CHECKING METHODS:
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