TY - JOUR
T1 - Surgical Intervention Strategies of Necrotizing Pancreatitis With Abdominal Compartment Syndrome
AU - Kao, Shih Yi
AU - Chen, Tien Hua
AU - Wang, Chien Ying
AU - Hsiao, Chen Yuan
AU - Chiang, Ching Shu
AU - Chou, Shu Cheng
AU - Chen, Jui Yu
AU - Tsai, Pei Jiun
N1 - Funding Information:
The study was conducted in accordance with the Declaration of Helsinki, and the study protocol was approved by the institutional review board of the Taipei Veterans General Hospital (approval number: 2019-10-002CC). The written informed consent from the participants for this retrospective study was waived by the institutional review board. This study was sponsored by grants from Ten-Chan General Hospital Zhongli, Taipei Veterans General Hospital (V108C-044, V109C-130, V108B-002, V109C-131), the Ministry of Science and Technology (MOST 107-2314-B-010-056-MY3, MOST 108-2314-B-010-053), and Taiwan Association of Cardiovascular Surgery Research. We declare that the sponsors of the study and the authors have no conflicts of interest to report. The funding sources had no role in the study design, data collection, data interpretation, data analysis, or writing of the report.
Funding Information:
This study was sponsored by grants from Ten-Chan General Hospital Zhongli, Taipei Veterans General Hospital (V108C-044, V109C-130, V108B-002, V109C-131), the Ministry of Science and Technology (MOST 107-2314-B-010-056-MY3, MOST 108-2314-B-010-053), and Taiwan Association of Cardiovascular Surgery Research. We declare that the sponsors of the study and the authors have no conflicts of interest to report. The funding sources had no role in the study design, data collection, data interpretation, data analysis, or writing of the report.
Publisher Copyright:
Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
PY - 2021
Y1 - 2021
N2 - Objective: Acute pancreatitis can usually recover after conservative treatment. Five to 10 percent of acute pancreatitis may proceed into peripancreatic fluid collection and necrosis development, called necrotizing pancreatitis (NP), which has a high mortality rate. If it is accompanied by the occurrence of abdominal compartment syndrome (ACS) and does not respond to medical therapy, surgical intervention is indicated. Methods: We analyzed our experience of surgical intervention strategies for NP patients with medically irreversible ACS from January 1, 2004, to December 31, 2018. Results: Of the 47 NP patients with ACS, mean Ranson score was 6.5, mean Acute Physiology and Chronic Health Evaluation II score was 22.2, and Modified computed tomography severity index score was all 8 or greater. The mean total postoperative hospital length of stay was 80.2 days, of which the mean intensive care unit length of stay was 16.6 days. The overall complication rate was 31.9%. The mortality rate was 8.5%. Among the 47 patients, only fungemia was significantly associated with mortality incidence. Conclusions: The combination of multiple drainage tube placement, feeding jejunostomy, and ileostomy at the same time were effective surgical intervention strategies for NP patients with ACS, which brought a lower mortality rate.
AB - Objective: Acute pancreatitis can usually recover after conservative treatment. Five to 10 percent of acute pancreatitis may proceed into peripancreatic fluid collection and necrosis development, called necrotizing pancreatitis (NP), which has a high mortality rate. If it is accompanied by the occurrence of abdominal compartment syndrome (ACS) and does not respond to medical therapy, surgical intervention is indicated. Methods: We analyzed our experience of surgical intervention strategies for NP patients with medically irreversible ACS from January 1, 2004, to December 31, 2018. Results: Of the 47 NP patients with ACS, mean Ranson score was 6.5, mean Acute Physiology and Chronic Health Evaluation II score was 22.2, and Modified computed tomography severity index score was all 8 or greater. The mean total postoperative hospital length of stay was 80.2 days, of which the mean intensive care unit length of stay was 16.6 days. The overall complication rate was 31.9%. The mortality rate was 8.5%. Among the 47 patients, only fungemia was significantly associated with mortality incidence. Conclusions: The combination of multiple drainage tube placement, feeding jejunostomy, and ileostomy at the same time were effective surgical intervention strategies for NP patients with ACS, which brought a lower mortality rate.
KW - Abdominal compartment syndrome
KW - Feeding jejunostomy
KW - Ileostomy
KW - Multiple drainage
KW - Necrotizing pancreatitis
KW - Surgical intervention
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U2 - 10.1097/MPA.0000000000001949
DO - 10.1097/MPA.0000000000001949
M3 - Article
C2 - 35041341
AN - SCOPUS:85123655624
SN - 0885-3177
VL - 50
SP - 1415
EP - 1421
JO - Pancreas
JF - Pancreas
IS - 10
ER -
