Safety and efficacy of conservative management in acute severe pancreatitis

Acute severe pancreatitis represents a disease with multiple complications and a high mortality rate. The clinical evolution is related to the acute systemic inflammatory response syndrome, due mainly to inflammatory mediators and pancreatic enzymes and to the infectious complications representing a peak in the incidence of death. This study aims to retrospectively analyse the outcome of patients diagnosed with acute severe pancreatitis, conservatively treated versus those surgically managed. This study includes 151 patients, each having been diagnosed with acute severe pancreatitis (CT using Balthazar's) distributed in term of age, sex and severity parameters. The conservative treatment has included antibiotics, and anti-inflammatory drugs. The imaging and biological parameters were further statistically analysed. The clinical-biological evolution has been paralleled by the CT severity index. The conservatively treated group had a better clinical-biological outcome (p<0.05), when compared with the surgically treated group. Morbidity was significantly higher in the group exposed to surgical treatment. Conservative treatment should be the first option in acute severe pancreatitis management.