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Pancreatic abscess: an unresolved surgical problem

G V Aranha, R A Prinz, H B Greenlee

    American Journal of Surgery
    |November 1, 1982
    PubMed
    Summary

    Pancreatic abscesses remain dangerous, but advances like imaging and sump drainage improve survival. Nutritional support may also reduce mortality in these critical cases.

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    Area of Science:

    • Gastroenterology
    • Surgical Oncology
    • Abdominal Imaging

    Background:

    • Pancreatic abscesses are severe complications, often arising from alcoholic pancreatitis or prior surgery.
    • Historically, pancreatic abscesses carried a high mortality rate.
    • Recent diagnostic and therapeutic advancements warrant evaluation for improved patient outcomes.

    Purpose of the Study:

    • To assess the impact of recent diagnostic and therapeutic advances on the prognosis of patients with pancreatic abscesses.
    • To evaluate the effectiveness of ultrasonography and computerized tomographic scanning in diagnosing and localizing pancreatic abscesses.
    • To determine the influence of surgical drainage techniques and nutritional support on operative mortality.

    Main Methods:

    • Retrospective study of 20 patients diagnosed with pancreatic abscesses.
    • Utilized ultrasonography and computerized tomographic scanning for diagnosis and localization.
    • Surgical intervention was performed on all patients, with varied drainage methods (sump vs. Penrose drains) and nutritional support (hyperalimentation).

    Main Results:

    • Operative mortality was 30%, primarily due to sepsis-induced multiple system failure.
    • Sump drainage was associated with significantly lower mortality (2/15 deaths) compared to Penrose drains alone (3/4 deaths).
    • Patients receiving nutritional support had a lower mortality rate (2/10 deaths) than those without (4/10 deaths).

    Conclusions:

    • Pancreatic abscesses continue to be life-threatening conditions requiring prompt management.
    • Advanced imaging techniques like ultrasonography and CT scanning are crucial for accurate diagnosis and localization.
    • Sump drainage and nutritional support represent significant therapeutic improvements, substantially reducing mortality rates from historical levels.

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