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Multidisciplinary interventional approach in management of acute pancreatitis-changing trends over the time
Abhinav Gupta1, Jyoti Jindal1, Vikas Garg1
1Department of Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
Objective:
To evaluate the effect of multidisciplinary management on mortality and morbidity in acute pancreatitis (AP) patients and to investigate the clinical profile and intervention requirements in patients with peripancreatic collections.
Materials And Methods:
A prospective observational study was conducted in 100 AP patients admitted to a tertiary care hospital in Ludhiana. Statistical analysis was performed using SPSS21 software (SPSS Inc., Chicago, IL, USA).
Results:
Of the 100 cases, 27% were in the 31-40 age group, with a male predominance (67%) and biliary etiology (44%). Radiological evidence of pancreatitis was present in 90% of cases, with peripancreatic collections in 53%. Interventions included nasojejunal feeding tube (NJFT) (66%), Percutaneous catheter drainage (PCD) insertion (34%), necrosectomy (11%), therapeutic endoscopic retrograde cholangiopancreatography (5%), and cholecystectomy (3%). Out of 100 patients, there was need for ICU admission in 58%, ventilatory support in 25%, and inotropes in 31% of the patients. Bacterial growth was detected in 90.9% of peripancreatic collection samples, with Klebsiella being the most common isolate. The mean length of stay was 19 days, with a final outcome of discharge (71%), discharge against medical advice (24%), and mortality (5%).
Conclusion:
This study demonstrates a significant relationship between the severity of AP and the need for interventions, which affects the final outcome of patients, resulting in decreased morbidity and mortality.
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