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Decreased mortality from necrotizing pancreatitis
D Oleynikov1, C Cook, B Sellers
1Department of Surgery, University of Utah Health Sciences Center, Salt Lake City 84132, USA.
American Journal of Surgery
|February 2, 1999
Summary
Aggressive surgical debridement and comprehensive critical care significantly improved survival rates for patients with necrotizing pancreatitis, reducing mortality in a retrospective review.
Area of Science:
- Gastroenterology
- Surgical Critical Care
Background:
- Necrotizing pancreatitis carries a high mortality rate, ranging from 25% to 80%.
- This study evaluates the impact of aggressive surgical and critical care interventions.
Purpose of the Study:
- To determine if aggressive debridement and comprehensive critical care improve survival in necrotizing pancreatitis.
- To analyze factors associated with poor outcomes in these patients.
Main Methods:
- Retrospective review of 989 pancreatitis patients admitted between January 1990 and September 1997.
- Focus on 26 patients who underwent surgery for necrotizing pancreatitis.
Main Results:
- A mortality rate of 19% (5 out of 26 patients) was observed.
- Poor outcomes correlated with infected pancreatic necrosis, elevated APACHE II scores, and worsening Multiple Organ Dysfunction (MOD) scores.
- Mean Ranson's score was 4.3, APACHE II score was 17.2, and MOD score was 9.1.
Conclusions:
- Comprehensive surgical and critical care strategies enhance survival for critically ill patients with necrotizing pancreatitis.
- Early identification and management of complications like infected necrosis are crucial.