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Revista del Nacional (Itauguá)
Print version ISSN 2072-8174
Abstract
FRANCO LOPEZ, Jessica; FERREIRA BOGADO, Miguel and BARUJA, Rubén. Surgical clinical management of necrotizing pancreatitis in adults: experience in a specialized hospital, Paraguay. Rev. Nac. (Itauguá) [online]. 2024, vol.16, n.1, pp.69-80. ISSN 2072-8174. https://doi.org/10.18004/rdn2024.ene.01.069.080.
Introduction:
pancreatic necrosis occurs between 10 and 20 % of patients with pancreatitis, has a mortality of 10 to 25 % and if infection is added to the necrosis between 40 and 70 %.
Objective:
to describe the surgical and clinical management of infected necrotizing pancreatitis in patients admitted to the General Surgery Service of the Hospital Nacional between the period 2021-2022.
Methodology:
this was an observational, descriptive and cross-section study with a temporal cut. We included patients admitted to the general surgery service of the National Hospital with severe acute pancreatitis with infected necrotizing pancreatitis.
Results:
a total of 30 patients were included. The mean age was 39 years. Male patients prevailed in our population in 56.67 %. Regarding the associated comorbidities, 33.3 % of the patients presented mainly type 2 diabetes mellitus and arterial hypertension; to a lesser extent Obesity in 23.3 %. In the study population, 76.6 % received surgical treatment and 23.33 % medical treatment, mainly antibiotic therapy. Of the patients who underwent surgical treatment, 9 were open necrosectomy, 7 had percutaneous drainage, and to a lesser extent biliary and endoscopic drainage. Regarding mortality due to infected necrotizing pancreatitis, we found a 10% mortality.
Discussion:
most of the patients with severe acute pancreatitis suffer from necrotizing pancreatitis; infected necrotizing pancreatitis is associated with increased risk of mortality and most require invasive treatment.
Conclusion:
minimally invasive management in the initial treatment of infected necrotizing pancreatitis, which could resolve most cases without the need to perform necrosectomy; the latter should be reserved for those who fail the initial treatment.
Keywords : Infected necrotizing pancreatitis; Severe Pancreatitis; Minimally invasive treatment.