Endoscopic ultrasound criteria to predict the need for intervention in pancreatic necrosis.

BMC Gastroenterology
Christian JürgensenJochen Hampe

Abstract

The natural course and treatment strategies for asymptomatic or oligosymptomatic pancreatic necrosis are still poorly defined. The aim of this retrospective study was to establish criteria for the need of intervention in patients with pancreatic necrosis. A total of 31 consecutive patients (18 male, median age 58 yrs.) diagnosed with pancreatic necrosis by endoscopic ultrasound, in whom a decision for initial conservative treatment was made, were followed for the need of interventions such as endoscopic or surgical intervention, or death. After a median follow-up of 243 days, 21 patients remained well without intervention and in 10 patients an endpoint event occurred. In a multivariate logistic regression analysis of the clinical and endosonographic parameters, liquid content was the single independent predictor for intervention (p = 0.0006). The presence of high liquid content in the pancreatic necrosis resulted in a 64% predicted endpoint risk as compared to 2% for solid necrosis. Pancreatic necrotic cavities with high liquid content are associated with a high risk of complications. Therefore, close clinical monitoring is needed and early elective intervention might be considered in these patients.

References

Nov 19, 2002·Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]·Waldemar UhlUNKNOWN International Association of Pancreatology
Jan 28, 2004·Scandinavian Journal of Gastroenterology. Supplement·V B NieuwenhuijsH G Gooszen
Mar 23, 2005·Pancreas·Michael RunziPeter Layer
Apr 16, 2005·Gut·UNKNOWN Working Party of the British Society of GastroenterologyUNKNOWN Association of Upper GI Surgeons of Great Britain and Ireland
Mar 8, 2006·The British Journal of Surgery·M G BesselinkUNKNOWN Dutch Acute Pancreatitis Study Group
May 9, 2007·Gastroenterology·Chris E ForsmarkUNKNOWN AGA Institute Governing Board
Oct 30, 2007·Gastrointestinal Endoscopy·Rogier P VoermansPaul Fockens
May 24, 2008·Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]·Ilse M SchroverRobin Timmer
May 2, 2009·Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]·V BeckerR M Schmid
Apr 23, 2010·The New England Journal of Medicine·Hjalmar C van SantvoortUNKNOWN Dutch Pancreatitis Study Group
Aug 25, 2010·Gut·Hjalmar C van SantvoortUNKNOWN Dutch Pancreatitis Study Group

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