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Author Spotlight: Advancements in Retroperitoneal Approach for Necrotizing Pancreatitis
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[Infected pancreatic necrosis: Treatment with antibiotics alone. Would this be the first step of the step-up

Jorge A Obeid1, Oscar D Brosutti1, Emilio M García Calcaterra1

  • 1Servicio de Cirugía General, Hospital J. B. Iturraspe, Santa Fe, Argentina.

Medicina
|June 28, 2023
PubMed
Abstract

Insights

Conservative antibiotic treatment for infected pancreatic necrosis (IPN) shows good outcomes in selected patients. This approach avoids invasive drainage procedures, simplifying management and improving patient recovery.

Area of Science:

  • Gastroenterology
  • Surgical Infections
  • Pancreatic Diseases

Background:

  • Infected pancreatic necrosis (IPN) management has evolved since initial case reports.
  • Antibiotic-only treatment for IPN has demonstrated positive outcomes in prior case series.
  • Conservative approaches are increasingly explored for IPN management.

Observation:

  • This study reviewed 25 patients diagnosed with IPN between January 2018 and October 2020.
  • Eleven patients received conservative management, including antibiotics, hydration, and nutritional support.
  • Diagnosis relied on CT findings of retroperitoneal gas or clinical deterioration without other infection sources.

Findings:

  • All eleven conservatively treated patients received antibiotics for over three weeks.
  • No patients required parenteral nutrition, and the average hospital stay was 38 days.
  • Three patients were readmitted, and eight underwent cholecystectomy post-recovery; no mortality was observed.

Implications:

  • Selected cases of IPN can be effectively managed conservatively with antibiotics alone.
  • Non-operative management of IPN may reduce the need for invasive drainage procedures.
  • This strategy offers a viable alternative, potentially improving patient outcomes and resource utilization.
Keywords:
acute pancreatitisantibioticinfected pancreatic necrosisnecrotizing pancreatitispancreatic necrosistreatment

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