BACKGROUND: Necrotizing pancreatitis survivors develop complications beyond infected necrosis that often require invasive intervention. Remarkably few data have cataloged these late complications after acute necrotizing pancreatitis resolution. We sought to identify the types and incidence of complications after necrotizing pancreatitis. DESIGN: An observational study was performed evaluating 647 patients with necrotizing pancreatitis captured in a single-institution database between 2005 and 2017 at a tertiary care hospital. Retrospective review and analysis of newly diagnosed conditions attributable to necrotizing pancreatitis was performed. Exclusion criteria included the following: death before disease resolution (n = 57, 9%) and patients lost to follow-up (n = 12, 2%). RESULTS: A total of 578 patients were followed for a median of 46 months (range, 8 months to 15 y) after necrotizing pancreatitis. In 489 (85%) patients 1 or more complications developed and included symptomatic disconnected pancreatic duct syndrome (285 of 578, 49%), splanchnic vein thrombosis (257 of 572, 45%), new endocrine insufficiency (195 of 549, 35%), new exocrine insufficiency (108 of 571, 19%), symptomatic chronic pancreatitis (93 of 571, 16%), incisional hernia (89 of 420, 21%), biliary stricture (90 of 576, 16%), chronic pain (44 of 575, 8%), gastrointestinal fistula (44 of 578, 8%), pancreatic duct stricture (30 of 578, 5%), and duodenal stricture (28 of 578, 5%). During the follow-up period, a total of 340 (59%) patients required an invasive intervention after necrotizing pancreatitis resolution. Invasive pancreatobiliary intervention was required in 230 (40%) patients. CONCLUSION: Late complications are common in necrotizing pancreatitis survivors. A broad variety of problems manifest themselves after resolution of the acute disease process and often require invasive intervention. Necrotizing pancreatitis patients should be followed lifelong by experienced clinicians.
BACKGROUND:Necrotizing pancreatitis survivors develop complications beyond infected necrosis that often require invasive intervention. Remarkably few data have cataloged these late complications after acute necrotizing pancreatitis resolution. We sought to identify the types and incidence of complications after necrotizing pancreatitis. DESIGN: An observational study was performed evaluating 647 patients with necrotizing pancreatitis captured in a single-institution database between 2005 and 2017 at a tertiary care hospital. Retrospective review and analysis of newly diagnosed conditions attributable to necrotizing pancreatitis was performed. Exclusion criteria included the following: death before disease resolution (n = 57, 9%) and patients lost to follow-up (n = 12, 2%). RESULTS: A total of 578 patients were followed for a median of 46 months (range, 8 months to 15 y) after necrotizing pancreatitis. In 489 (85%) patients 1 or more complications developed and included symptomatic disconnected pancreatic duct syndrome (285 of 578, 49%), splanchnic vein thrombosis (257 of 572, 45%), new endocrine insufficiency (195 of 549, 35%), new exocrine insufficiency (108 of 571, 19%), symptomatic chronic pancreatitis (93 of 571, 16%), incisional hernia (89 of 420, 21%), biliary stricture (90 of 576, 16%), chronic pain (44 of 575, 8%), gastrointestinal fistula (44 of 578, 8%), pancreatic duct stricture (30 of 578, 5%), and duodenal stricture (28 of 578, 5%). During the follow-up period, a total of 340 (59%) patients required an invasive intervention after necrotizing pancreatitis resolution. Invasive pancreatobiliary intervention was required in 230 (40%) patients. CONCLUSION: Late complications are common in necrotizing pancreatitis survivors. A broad variety of problems manifest themselves after resolution of the acute disease process and often require invasive intervention. Necrotizing pancreatitispatients should be followed lifelong by experienced clinicians.
Authors: G Cavallini; L Frulloni; C Bassi; A Gabbrielli; L Castoldi; G Costamagna; P De Rai; V Di Carlo; M Falconi; R Pezzilli; G Uomo Journal: Dig Liver Dis Date: 2004-03 Impact factor: 4.088
Authors: Anne F Peery; Seth D Crockett; Alfred S Barritt; Evan S Dellon; Swathi Eluri; Lisa M Gangarosa; Elizabeth T Jensen; Jennifer L Lund; Sarina Pasricha; Thomas Runge; Monica Schmidt; Nicholas J Shaheen; Robert S Sandler Journal: Gastroenterology Date: 2015-08-29 Impact factor: 22.682
Authors: Maxim S Petrov; Satyanarayan Shanbhag; Mandira Chakraborty; Anthony R J Phillips; John A Windsor Journal: Gastroenterology Date: 2010-06-09 Impact factor: 22.682
Authors: Jorge D Machicado; Amir Gougol; Kimberly Stello; Gong Tang; Yongseok Park; Adam Slivka; David C Whitcomb; Dhiraj Yadav; Georgios I Papachristou Journal: Clin Gastroenterol Hepatol Date: 2017-06-01 Impact factor: 11.382
Authors: Peter A Banks; Thomas L Bollen; Christos Dervenis; Hein G Gooszen; Colin D Johnson; Michael G Sarr; Gregory G Tsiotos; Santhi Swaroop Vege Journal: Gut Date: 2012-10-25 Impact factor: 23.059
Authors: Robbert A Hollemans; Nora D L Hallensleben; David J Mager; Johannes C Kelder; Marc G Besselink; Marco J Bruno; Robert C Verdonk; Hjalmar C van Santvoort Journal: Pancreatology Date: 2018-02-20 Impact factor: 3.996
Authors: Andrew S Ross; Shayan Irani; S Ian Gan; Flavio Rocha; Justin Siegal; Mehran Fotoohi; Ellen Hauptmann; David Robinson; Robert Crane; Richard Kozarek; Michael Gluck Journal: Gastrointest Endosc Date: 2013-11-15 Impact factor: 9.427
Authors: Péter Hegyi; Andrea Szentesi; Szabolcs Kiss; József Pintér; Roland Molontay; Marcell Nagy; Nelli Farkas; Zoltán Sipos; Péter Fehérvári; László Pecze; Mária Földi; Áron Vincze; Tamás Takács; László Czakó; Ferenc Izbéki; Adrienn Halász; Eszter Boros; József Hamvas; Márta Varga; Artautas Mickevicius; Nándor Faluhelyi; Orsolya Farkas; Szilárd Váncsa; Rita Nagy; Stefania Bunduc; Péter Jenő Hegyi; Katalin Márta; Katalin Borka; Attila Doros; Nóra Hosszúfalusi; László Zubek; Bálint Erőss; Zsolt Molnár; Andrea Párniczky Journal: Sci Rep Date: 2022-05-12 Impact factor: 4.996
Authors: Thomas K Maatman; Sean P McGuire; Katelyn F Flick; Mackenzie K Madison; Mohammad A Al-Haddad; Benjamin L Bick; Eugene P Ceppa; John M DeWitt; Jeffrey J Easler; Evan L Fogel; Mark A Gromski; Michael G House; Glen A Lehman; Attila Nakeeb; C Max Schmidt; Stuart Sherman; James L Watkins; Nicholas J Zyromski Journal: Ann Surg Date: 2021-09-01 Impact factor: 13.787