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Journal of Gastrointestinal Surgery

, Volume 14, Issue 2, pp 245–251 | Cite as

Characteristics and Outcomes of Patients Undergoing Debridement of Pancreatic Necrosis

  • Sebron Harrison
  • Manasi Kakade
  • Shyam Varadarajula
  • Justin Parden
  • Desiree Morgan
  • John ChristeinEmail author
2009 SSAT Plenary Presentation

Abstract

Background

Pancreatic necrosis is associated with high morbidity and mortality. The Atlanta Classification underwent proposed revisions in 2007 to better categorize acute pancreatitis.

Methods

From 1999 to 2008, patients with pancreatic necrosis treated with surgical debridement were analyzed. Computed tomography (CT) images were independently reviewed to classify of pancreatic collections according to the revised Atlanta classification.

Results

Seventy-three patients were categorized as infected extrapancreatic necrosis (40%), sterile extrapancreatic necrosis (29%), infected pancreatic necrosis (15%), sterile pancreatic necrosis (11%), or post-necrotic collection (5%). Mortality was 14%, and morbidity was 55%. Debridement with external drainage or open packing was associated with higher mortality than cystgastrostomy (p = 0.03). Atlanta Classification was not associated with operative procedure or mortality. Degree of chronic disease, demonstrated by albumin level, and infection were associated with longer stay (p < 0.05).

Conclusion

Type of necrosis by the revised Atlanta Classification was not associated with outcomes or type of operation. Debridement by cystgastrostomy was associated with lower mortality rates than external drainage or open packing. Length of stay was increased in patients with evidence of chronic disease, infection, and postoperative complications. Necrotizing pancreatitis continues to be associated with significant morbidity and mortality and should undergo aggressive treatment at tertiary care centers.

Keywords

Acute pancreatitis Pancreatic necrosis Pancreatic debridement Cystgastrostomy Infected necrosis 

Notes

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Copyright information

© The Society for Surgery of the Alimentary Tract 2009

Authors and Affiliations

  • Sebron Harrison
    • 1
  • Manasi Kakade
    • 2
  • Shyam Varadarajula
    • 3
  • Justin Parden
    • 4
  • Desiree Morgan
    • 5
  • John Christein
    • 2
    Email author
  1. 1.Department of Surgery, School of MedicineUniversity of Alabama at BirminghamBirminghamUSA
  2. 2.Section of Gastrointestinal Surgery, Department of SurgeryUniversity of Alabama at BirminghamBirminghamUSA
  3. 3.Division of Gastroenterology, Department of MedicineUniversity of Alabama at BirminghamBirminghamUSA
  4. 4.School of MedicineUniversity of Alabama at BirminghamBirminghamUSA
  5. 5.Department of RadiologyUniversity of Alabama at BirminghamBirminghamUSA

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