Cargando…

Acute necrotizing pancreatitis: Has conservative management replaced surgery? Perspective from a tertiary care centre in Pakistan: A cross-sectional study

BACKGROUND: The main purpose of this study was to review the trends in management of patients presenting with acute necrotizing pancreatitis (ANP) over the last seven years and its effect on morbidity and mortality. METHODS: A cross-sectional study was conducted on all patients presenting with the d...

Descripción completa

Detalles Bibliográficos
Autores principales: Mannan, Fatima, Gill, Roger Christopher, Sohail, Abdul Ahad, Alvi, Rehman, Ahmad, Khabir
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Fla
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7905362/
https://www.ncbi.nlm.nih.gov/pubmed/33664946
http://dx.doi.org/10.1016/j.amsu.2021.02.005
_version_ 1783655097810550784
author Mannan, Fatima
Gill, Roger Christopher
Sohail, Abdul Ahad
Alvi, Rehman
Ahmad, Khabir
author_facet Mannan, Fatima
Gill, Roger Christopher
Sohail, Abdul Ahad
Alvi, Rehman
Ahmad, Khabir
author_sort Mannan, Fatima
collection PubMed
description BACKGROUND: The main purpose of this study was to review the trends in management of patients presenting with acute necrotizing pancreatitis (ANP) over the last seven years and its effect on morbidity and mortality. METHODS: A cross-sectional study was conducted on all patients presenting with the diagnosis of acute necrotizing pancreatitis to the Aga Khan University Hospital in between the year 2008–2015. The study population was broadly categorized in to two groups based on the way these were managed. The first group consisted of patient who underwent surgery for acute necrotizing pancreatitis while the second group was composed of those patients with necrotizing pancreatitis who were conservatively managed. Patient outcomes were assessed in terms of hospital stay, complication rates and in-hospital mortality. Data was analyzed using SPSS version 20. Comparison of outcomes between two groups was done using chi-square test, Fischer exact test or t-test wherever applicable. A p-value of less than 0.05 was considered statistically significant. RESULTS: A total of n = 110 patients were included in the study with 68% (n = 75) males and 32% (n = 35) females. Nasojejunal route was found to be the most commonly utilized route of feeding in these patients consisting of around 49% (n = 54) patients with forty percent (n = 44) tolerating direct oral diet. The outcomes in both these groups in terms of hospital stay, complication rate, and in hospital mortality were not found to be statistically significant. The conservative group however was significant in terms of cost-effectiveness which was shown by a p value of (0.035). The management of this clinically important disease over the years showed an increased trend towards conservative approach in our institute. CONCLUSION: Our study further substantiates the recent global trend of conservative approach towards managing patients with acute necrotizing pancreatitis as reflected in the recent available literature. Therefore surgeons of the developing world need to evolve and adapt to these new measures for better outcomes in patient management.
format Online
Article
Text
id pubmed-7905362
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-79053622021-03-03 Acute necrotizing pancreatitis: Has conservative management replaced surgery? Perspective from a tertiary care centre in Pakistan: A cross-sectional study Mannan, Fatima Gill, Roger Christopher Sohail, Abdul Ahad Alvi, Rehman Ahmad, Khabir Ann Med Surg (Lond) Fla BACKGROUND: The main purpose of this study was to review the trends in management of patients presenting with acute necrotizing pancreatitis (ANP) over the last seven years and its effect on morbidity and mortality. METHODS: A cross-sectional study was conducted on all patients presenting with the diagnosis of acute necrotizing pancreatitis to the Aga Khan University Hospital in between the year 2008–2015. The study population was broadly categorized in to two groups based on the way these were managed. The first group consisted of patient who underwent surgery for acute necrotizing pancreatitis while the second group was composed of those patients with necrotizing pancreatitis who were conservatively managed. Patient outcomes were assessed in terms of hospital stay, complication rates and in-hospital mortality. Data was analyzed using SPSS version 20. Comparison of outcomes between two groups was done using chi-square test, Fischer exact test or t-test wherever applicable. A p-value of less than 0.05 was considered statistically significant. RESULTS: A total of n = 110 patients were included in the study with 68% (n = 75) males and 32% (n = 35) females. Nasojejunal route was found to be the most commonly utilized route of feeding in these patients consisting of around 49% (n = 54) patients with forty percent (n = 44) tolerating direct oral diet. The outcomes in both these groups in terms of hospital stay, complication rate, and in hospital mortality were not found to be statistically significant. The conservative group however was significant in terms of cost-effectiveness which was shown by a p value of (0.035). The management of this clinically important disease over the years showed an increased trend towards conservative approach in our institute. CONCLUSION: Our study further substantiates the recent global trend of conservative approach towards managing patients with acute necrotizing pancreatitis as reflected in the recent available literature. Therefore surgeons of the developing world need to evolve and adapt to these new measures for better outcomes in patient management. Elsevier 2021-02-18 /pmc/articles/PMC7905362/ /pubmed/33664946 http://dx.doi.org/10.1016/j.amsu.2021.02.005 Text en © 2021 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Fla
Mannan, Fatima
Gill, Roger Christopher
Sohail, Abdul Ahad
Alvi, Rehman
Ahmad, Khabir
Acute necrotizing pancreatitis: Has conservative management replaced surgery? Perspective from a tertiary care centre in Pakistan: A cross-sectional study
title Acute necrotizing pancreatitis: Has conservative management replaced surgery? Perspective from a tertiary care centre in Pakistan: A cross-sectional study
title_full Acute necrotizing pancreatitis: Has conservative management replaced surgery? Perspective from a tertiary care centre in Pakistan: A cross-sectional study
title_fullStr Acute necrotizing pancreatitis: Has conservative management replaced surgery? Perspective from a tertiary care centre in Pakistan: A cross-sectional study
title_full_unstemmed Acute necrotizing pancreatitis: Has conservative management replaced surgery? Perspective from a tertiary care centre in Pakistan: A cross-sectional study
title_short Acute necrotizing pancreatitis: Has conservative management replaced surgery? Perspective from a tertiary care centre in Pakistan: A cross-sectional study
title_sort acute necrotizing pancreatitis: has conservative management replaced surgery? perspective from a tertiary care centre in pakistan: a cross-sectional study
topic Fla
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7905362/
https://www.ncbi.nlm.nih.gov/pubmed/33664946
http://dx.doi.org/10.1016/j.amsu.2021.02.005
work_keys_str_mv AT mannanfatima acutenecrotizingpancreatitishasconservativemanagementreplacedsurgeryperspectivefromatertiarycarecentreinpakistanacrosssectionalstudy
AT gillrogerchristopher acutenecrotizingpancreatitishasconservativemanagementreplacedsurgeryperspectivefromatertiarycarecentreinpakistanacrosssectionalstudy
AT sohailabdulahad acutenecrotizingpancreatitishasconservativemanagementreplacedsurgeryperspectivefromatertiarycarecentreinpakistanacrosssectionalstudy
AT alvirehman acutenecrotizingpancreatitishasconservativemanagementreplacedsurgeryperspectivefromatertiarycarecentreinpakistanacrosssectionalstudy
AT ahmadkhabir acutenecrotizingpancreatitishasconservativemanagementreplacedsurgeryperspectivefromatertiarycarecentreinpakistanacrosssectionalstudy