Abstract | BACKGROUND: MATERIALS AND METHODS: Six-year prospective audit of patients treated by a single surgeon, with an interest in pancreatic disease, within a Low Volume Hospital (LVH) setting. Results are presented as median (IQR). RESULTS: During the study period 18 patients (9 males) with complicated severe acute pancreatitis underwent radical pancreatic resection. The median age was 61 years (range 36-69). The median time to operation after presentation was 27 days (range 2-74). Microbiological culture confirmed infection in 14 (78%) patients. Three patients (17%) died within 30 days of operation. Twelve of the 15 survivors (80%) underwent a single operative procedure. Three patients required a further laparotomy, of whom 2 required colectomy for ischemia. Median hospital and ICU stays were 43 (range 30-57) and 5 (range 4-6) days respectively. Six patients (40% of survivors) developed an infection of the left half of the chevron incision; however, all wounds were fully healed within 3 months. Long-term follow-up of survivors (n=14) revealed 8 (57%) to need at least occasional pancreatic enzyme supplementation and 5 (36%) to have diabetes mellitus. Two patients (14%) developed an incisional hernia. CONCLUSIONS: Radical resection of pancreas and spleen, combined with postoperative irrigation, was associated with comparatively low rates of morbidity and mortality for patients with infected pancreatic necrosis in a LVH setting.
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Authors | Justin Davies, Stevan G Stojkovic, David Duffy, David J Alexander |
Journal | World journal of surgery
(World J Surg)
Vol. 30
Issue 6
Pg. 965-71; discussion 972-5
(Jun 2006)
ISSN: 0364-2313 [Print] United States |
PMID | 16736321
(Publication Type: Journal Article)
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Topics |
- Adult
- Aged
- Bacterial Infections
(complications)
- Debridement
- Drainage
- Female
- Humans
- Male
- Middle Aged
- Pancreatectomy
(methods)
- Pancreatitis, Acute Necrotizing
(microbiology, surgery)
- Postoperative Care
- Postoperative Complications
- Splenectomy
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