OBJECTIVE: To evaluate risk factors, results of treatment, and prognostic influence of complications on survival from acute necrotising pancreatitis. DESIGN: Retrospective study of prospectively collected data. SETTING: Tertiary referral centre, Austria. SUBJECTS: 100 consecutive patients operated on for necrotising pancreatitis confirmed by dynamic angio-computed tomography from 1988-1997. INTERVENTIONS: 77 patients were operated on acutely followed by open management, and in 23 the operations were delayed. MAIN OUTCOME MEASURES: Morbidity, mortality, factors predisposing to complications, prognostic effect of complications on survival. RESULTS: Acute operations, alcoholic origin, APACHE II scores of > or = 10 on admission, and organ dysfunction on admission were independent factors that predisposed patients to complications. Colonic necrosis (n = 17) bleeding (n = 12) and intestinal fistulisation (n = 10) predominated. The overall mortality of complicated pancreatic necrosis was higher among patients admitted with surgical complications than in those who were not, but not significantly so (12/33 compared with 7/44 p = 0.06). Colonic necrosis (mortality 53%, relative risk: 2.45, p = 0.01), however, seemed to be of prognostic relevance. CONCLUSIONS: Complications are common in severe necrotising pancreatitis leading to organ dysfunction and need for acute operations. Colonic necrosis is an independent prognostic factor for survival.
OBJECTIVE: To evaluate risk factors, results of treatment, and prognostic influence of complications on survival from acute necrotising pancreatitis. DESIGN: Retrospective study of prospectively collected data. SETTING: Tertiary referral centre, Austria. SUBJECTS: 100 consecutive patients operated on for necrotising pancreatitis confirmed by dynamic angio-computed tomography from 1988-1997. INTERVENTIONS: 77 patients were operated on acutely followed by open management, and in 23 the operations were delayed. MAIN OUTCOME MEASURES: Morbidity, mortality, factors predisposing to complications, prognostic effect of complications on survival. RESULTS: Acute operations, alcoholic origin, APACHE II scores of > or = 10 on admission, and organ dysfunction on admission were independent factors that predisposed patients to complications. Colonic necrosis (n = 17) bleeding (n = 12) and intestinal fistulisation (n = 10) predominated. The overall mortality of complicated pancreatic necrosis was higher among patients admitted with surgical complications than in those who were not, but not significantly so (12/33 compared with 7/44 p = 0.06). Colonic necrosis (mortality 53%, relative risk: 2.45, p = 0.01), however, seemed to be of prognostic relevance. CONCLUSIONS: Complications are common in severe necrotising pancreatitis leading to organ dysfunction and need for acute operations. Colonic necrosis is an independent prognostic factor for survival.
Authors: Jinoo Kim; Ji Hoon Shin; Hyun Ki Yoon; Gi Young Ko; Dong Il Gwon; Eun Young Kim; Kyu Bo Sung Journal: Diagn Interv Radiol Date: 2015 Mar-Apr Impact factor: 2.630