Abstract | BACKGROUND: STUDY DESIGN: The records of patients diagnosed with acute necrotizing pancreatitis from January 1993 through June 2000 were reviewed retrospectively. Data were analyzed with respect to Ranson's, APACHE II, and multiple organ failure scores, etiology, presence of infection, overall and ICU length of stay, time to first debridement, number of debridements, fluid requirements, days to enteral feeding, transfusion requirements, complications, and mortality. RESULTS: Twenty-six patients (18 males, 8 females, mean age 51 years) were diagnosed with acute necrotizing pancreatitis. The admission Ranson's score was 4.8, the APACHE II score was 11.7, and multiple organ failure score was 4.2. All but one patient underwent pancreatic debridement (4.3 debridements per patient). Eighteen patients (69%) had infected pancreatic necrosis. The timing of debridement was based on patients' condition and surgeon's preference. The presentation and demographics of patients who underwent early (<2 weeks) or late (>2 weeks) debridement did not differ significantly. Patients debrided early had a trend toward higher mortality (29% versus 18%) and experienced a higher number of major complications (p < 0.05). The six patients (23%) who died were older, had multiple organ failure scores, and more often had Candida in the infected necrosis (p < .05). CONCLUSIONS:
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Authors | Eric S Hungness, Bruce W Robb, Connie Seeskin, Per-Olof Hasselgren, Fred A Luchette |
Journal | Journal of the American College of Surgeons
(J Am Coll Surg)
Vol. 194
Issue 6
Pg. 740-4; discussion 744-5
(Jun 2002)
ISSN: 1072-7515 [Print] United States |
PMID | 12081064
(Publication Type: Journal Article)
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Topics |
- Age Factors
- Candidiasis
(complications)
- Debridement
(adverse effects, mortality)
- Female
- Humans
- Male
- Middle Aged
- Pancreatitis, Acute Necrotizing
(complications, mortality, surgery)
- Retrospective Studies
- Severity of Illness Index
- Time Factors
- Treatment Outcome
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