Lisa A Brown1, Todd A Hore2, Anthony R J Phillips3, John A Windsor4, Maxim S Petrov5. 1. The Department of Surgery, The University of Auckland, Auckland, New Zealand. Electronic address: l.brown@auckland.ac.nz. 2. The Department of Surgery, The University of Auckland, Auckland, New Zealand. Electronic address: toddnz@gmail.com. 3. The Department of Surgery, The University of Auckland, Auckland, New Zealand. Electronic address: a.phillips@auckland.ac.nz. 4. The Department of Surgery, The University of Auckland, Auckland, New Zealand. Electronic address: j.windsor@auckland.ac.nz. 5. The Department of Surgery, The University of Auckland, Auckland, New Zealand. Electronic address: m.petrov@auckland.ac.nz.
Abstract
BACKGROUND AND AIM: Extra-pancreatic infectious complications in acute pancreatitis increase morbidity, but their incidence and association with infected pancreatic necrosis is unknown. Half of bacterial cultures of pancreatic necrosis are of non-enteric origin, raising the possibility of other sources of infection. The aim of this systematic review was to assess the incidence of extra-pancreatic infectious complications in acute pancreatitis, their timing, and relation to severity of pancreatitis and mortality. METHODS: A systematic review was performed using Ovid MEDLINE, Embase and Cochrane Libraries, following PRISMA guidelines. Search terms were "Pancreatitis" AND "Infection" AND ("Complication" OR "Outcome"). RESULTS: 19 studies with 1741 patients were included. Extra-pancreatic infectious complication incidence was 32% (95% CI 23-41%), with the commonest being respiratory infection (9.2%) and bacteraemia (8.4%). Extra-pancreatic infectious complications were not associated with the predicted severity or the mortality of acute pancreatitis. Only 3 studies reported a relation of timing between extra-pancreatic and pancreatic infectious complications. CONCLUSIONS: This is the first systematic review to evaluate the incidence of extra-pancreatic infectious complications in acute pancreatitis, which a third of patients with acute pancreatitis will develop. Implications are vigilance and prompt treatment of extra-pancreatic infection, to reduce possibility of progression to infected pancreatic necrosis.
BACKGROUND AND AIM: Extra-pancreatic infectious complications in acute pancreatitis increase morbidity, but their incidence and association with infected pancreatic necrosis is unknown. Half of bacterial cultures of pancreatic necrosis are of non-enteric origin, raising the possibility of other sources of infection. The aim of this systematic review was to assess the incidence of extra-pancreatic infectious complications in acute pancreatitis, their timing, and relation to severity of pancreatitis and mortality. METHODS: A systematic review was performed using Ovid MEDLINE, Embase and Cochrane Libraries, following PRISMA guidelines. Search terms were "Pancreatitis" AND "Infection" AND ("Complication" OR "Outcome"). RESULTS: 19 studies with 1741 patients were included. Extra-pancreatic infectious complication incidence was 32% (95% CI 23-41%), with the commonest being respiratory infection (9.2%) and bacteraemia (8.4%). Extra-pancreatic infectious complications were not associated with the predicted severity or the mortality of acute pancreatitis. Only 3 studies reported a relation of timing between extra-pancreatic and pancreatic infectious complications. CONCLUSIONS: This is the first systematic review to evaluate the incidence of extra-pancreatic infectious complications in acute pancreatitis, which a third of patients with acute pancreatitis will develop. Implications are vigilance and prompt treatment of extra-pancreatic infection, to reduce possibility of progression to infected pancreatic necrosis.
Authors: Yaroslav M Susak; Olexandr O Dirda; Olexandr G Fedorchuk; Olekcandr A Tkachenko; Larysa M Skivka Journal: Dig Dis Sci Date: 2020-03-13 Impact factor: 3.199
Authors: Darshan Kothari; Maarten R Struyvenberg; Michael C Perillo; Ghideon Ezaz; Steven D Freedman; Sunil G Sheth Journal: Gastroenterol Rep (Oxf) Date: 2018-03-03