A contemporary series of patients undergoing open debridement for necrotizing pancreatitis - 14/08/14
Abstract |
Background |
For patients with acute pancreatitis complicated by infected necrosis, minimally invasive techniques have taken hold without substantial comparison with open surgery. We present a contemporary series of open necrosectomies as a benchmark for newer techniques.
Methods |
Using a prospective database, we retrospectively identified consecutive patients undergoing debridement for necrotizing pancreatitis (2006 to 2009). The primary endpoint was in-hospital mortality.
Results |
Sixty-eight patients underwent debridement for pancreatic/peripancreatic necrosis. In-hospital mortality was 8.8% (n = 6). Infection (n = 43, 63%) and failure-to-thrive (n = 13, 19%) comprised the most common indications for necrosectomy. The false negative rate (FNR) for infection of percutaneous aspirate was 20.0%. Older age (P = .02), Acute Physiology and Chronic Health Evaluation II score upon admission (P = .03) or preoperatively (P < .01), preoperative intensive care unit admission (P = .01), and postoperative organ failure (P = .03) were associated with mortality.
Conclusions |
Open debridement for necrotizing pancreatitis results in a low mortality, providing a useful comparator for other interventions. Given the high FNR of percutaneous aspirate, debridement should not be predicated on proven infection.
Le texte complet de cet article est disponible en PDF.Keywords : Pancreatic diseases, Acute necrotizing pancreatitis, Debridement, Minimally invasive surgical procedures, Sensitivity and specificity
Plan
| Current author affiliations: Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA (A.L. Madenci), Department of Surgery, University of Arizona, Phoenix, AZ, USA (M. Michailidou), Department of Surgery, Stanford University Medical Center, Palo Alto, CA, USA (G. Chiou). |
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| There were no relevant financial relationships or any sources of support in the form of grants, equipment, or drugs. |
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| The authors declare no conflicts of interest. |
Vol 208 - N° 3
P. 324-331 - septembre 2014 Retour au numéro
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