Surgical treatment for severe acute pancreatitis: extent and surgical control of necrosis determine outcome

World Journal of Surgery
Peter GötzingerReinhold Függer

Abstract

In patients operated on for severe acute pancreatitis (SAP), the factors determining outcome remain unclear. From 1986 to 1998 a total of 340 patients with a diagnosis of SAP and in need of operative treatment were admitted to the intensive care unit (ICU) of a university hospital and a secondary care hospital. The mean APACHE II score on the day of admission was 16.1 (range 8-35). All patients required operative therapy. Among the 340 patients, 270 (79.4%) had to be reoperated: 196 patients (72.6%) underwent operative revisions on demand, and 74 (27.4%) patients had preplanned reoperation. The overall mortality was 39.1% (133 patients). Septic organ failure in 126 patients (37.1%) and myocardial infarction or pulmonary embolism in 7 patients (2%) were the causes of death. The patient's age (p < 0.0002), APACHE II scores at admission (p < 0.0001), presence or development of (single or multiple) organ failure (p < 0.002), infection (p < 0.02) and extent (p < 0.04) of pancreatic necrosis, and surgical control of local necrosis (p < 0.0001) significantly determined survival. SAP that requires surgical treatment is associated with high in-hospital mortality. Surgical control of local necrosis is the precondition for survival. Advan...Continue Reading

Citations

Jun 28, 2007·Langenbeck's Archives of Surgery·Daniele GuiGiovanni B Doglietto
Feb 14, 2013·Surgical Endoscopy·Marek WrońskiIreneusz W Krasnodębski
Jun 12, 2004·Current Gastroenterology Reports·Michael G T RaratyJohn P Neoptolemos
Feb 11, 2005·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Pramod Kumar GargRakesh Kumar Tandon
Aug 9, 2003·Surgical Infections·Peter GötzingerThomas Sautner
Apr 18, 2007·Surgical Infections·Reinhold Függer
Sep 26, 2003·Pancreas·Zong-Guang ZhouZhao-Da Zhang
Dec 16, 2004·Critical Care Medicine·Avery B NathensCarl S Waldmann
Sep 1, 2007·Current Opinion in Gastroenterology·Matthew J DiMagno, Eugene P DiMagno
Feb 23, 2010·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Radhika LakshmananKrishnakumar Madhavan
Feb 10, 2012·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Marek WronskiIreneusz Wojciech Krasnodebski
Jul 6, 2006·World Journal of Emergency Surgery : WJES·Tercio De CamposSamir Rasslan
Jan 22, 2008·World Journal of Gastroenterology : WJG·Ibrahim-A Al Mofleh
Jan 22, 2011·World Journal of Gastroenterology : WJG·Nilesh DoctorSavio G Barreto
Apr 29, 2014·American Journal of Surgery·Arin L MadenciPeter J Fagenholz
Dec 24, 2008·Digestive Diseases and Sciences·Ping XueQing Xia
Mar 6, 2013·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Guntars PupelisViesturs Boka
Jul 12, 2011·Gastroenterology·Hjalmar C van SantvoortUNKNOWN Dutch Pancreatitis Study Group
Apr 2, 2011·Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]·Hairul A AhmadJeffrey M Hamdorf
Sep 25, 2014·Journal of Gastroenterology and Hepatology·Surinder S RanaDeepak K Bhasin
Aug 2, 2006·Gastroenterology Clinics of North America·Tyler M BerzinPeter A Banks
Aug 19, 2006·ANZ Journal of Surgery·Mettus ReddyJai Dev Wig
Jul 1, 2004·Acta Clinica Belgica·J De WaeleF Colardyn
Nov 7, 2007·The British Journal of Surgery·T L BollenUNKNOWN Dutch Acute Pancreatitis Study Group
Mar 6, 2013·ANZ Journal of Surgery·Srinivasan Ulagendra PerumalRavichandran Palaniappan
Jun 26, 2010·ANZ Journal of Surgery·A Peter WysockiC Ross Carter
Jul 19, 2005·Clinica Chimica Acta; International Journal of Clinical Chemistry·Ahmed Z Al-Bahrani, Basil J Ammori
Apr 26, 2005·Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]·Pietro RenzulliBeat Gloor
May 26, 2006·Expert Opinion on Pharmacotherapy·Jan J De Waele, Eric Hoste
Jun 24, 2015·AJR. American Journal of Roentgenology·Ken ZhaoFrank H Miller
Mar 14, 2014·Digestive Diseases and Sciences·Ragesh Babu ThandasseryRakesh Kochhar
May 22, 2016·Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology·Pankaj Singh, Pramod Kumar Garg
Apr 28, 2005·Surgery·S ConnorJ P Neoptolemos
Dec 4, 2003·The British Journal of Surgery·S ConnorJ P Neoptolemos
Oct 16, 2004·World Journal of Gastroenterology : WJG·Lei KongSheng-Dao Zhang

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