In:
Journal of Clinical Gastroenterology, Ovid Technologies (Wolters Kluwer Health), Vol. 50, No. 7 ( 2016-08), p. 589-595
Abstract:
To explore the diagnostic challenges, management, and clinical outcomes of patients with isolated peripancreatic necrosis (PPN), with emphasis on the extent of involvement, and compare them to pancreatic necrosis (PN). Background: PPN, a relatively new term, has been included as a separate entity in the Revised Atlanta Classification. Study: Clinical data of recruited acute pancreatitis patients were recorded prospectively. Contrast-enhanced computed tomographic scans were reviewed by expert radiologists blinded to clinical outcomes. Results: In total, 271 of the 400 acute pancreatitis patients underwent contrast-enhanced computed tomography, of which 29 (11%) had PPN (14: limited; 15: extensive) and 124 (46%) PN (40: 〈 30%, 16: 30% to 50%, 68: 〉 50% of parenchyma). Patients with PPN were similar to PN in age (56 y), gender (55% male), and body mass index (29 kg/m 2 ). Nutritional support was provided in 18 (62%) patients with PPN and 97 (78%) with PN ( P =0.12). Drainage/debridement was required in 2 patients (7%) with PPN and 64 (53%) with parenchymal necrosis ( P 〈 0.001). Persistent organ failure rates did not differ significantly (34% vs. 51%, P =0.17), but hospital stay was shorter in patients with PPN (15 vs. 20 d, P =0.05). Limited PPN required no intervention and had similar persistent organ failure rates and hospitalization length with interstitial pancreatitis (both P ≥0.12). Extensive PPN mainly developed in patients with persistent organ failure (60%) and rarely required drainage (2/15). Conclusions: PPN prevalence was lower than PN with a ratio of 1:4. PPN rarely required intervention. Utilizing the extent of involvement has the potential to classify PPN and PN with escalating clinical significance and guide management.
Type of Medium:
Online Resource
ISSN:
0192-0790
DOI:
10.1097/MCG.0000000000000482
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2016
detail.hit.zdb_id:
2041558-8
Bookmarklink