How to Identify the Indications for Early Intervention in Acute Necrotizing Pancreatitis Patients: A Long-Term Follow-Up Study

AimTo explore the indications for early intervention in patients with acute necrotizing pancreatitis (ANP) and evaluate the effect of early intervention on the prognosis of ANP patients.MethodsThe clinical data of patients with ANP who underwent general surgery at Xuanwu Hospital of Capital Medical...

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Main Authors: Jiongdi Lu, Feng Cao, Zhi Zheng, Yixuan Ding, Yuanxu Qu, Wentong Mei, Yulin Guo, Yu-Lu Feng, Fei Li
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-04-01
Series:Frontiers in Surgery
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fsurg.2022.842016/full
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author Jiongdi Lu
Jiongdi Lu
Feng Cao
Feng Cao
Zhi Zheng
Zhi Zheng
Yixuan Ding
Yixuan Ding
Yuanxu Qu
Yuanxu Qu
Wentong Mei
Wentong Mei
Yulin Guo
Yulin Guo
Yu-Lu Feng
Fei Li
Fei Li
author_facet Jiongdi Lu
Jiongdi Lu
Feng Cao
Feng Cao
Zhi Zheng
Zhi Zheng
Yixuan Ding
Yixuan Ding
Yuanxu Qu
Yuanxu Qu
Wentong Mei
Wentong Mei
Yulin Guo
Yulin Guo
Yu-Lu Feng
Fei Li
Fei Li
author_sort Jiongdi Lu
collection DOAJ
description AimTo explore the indications for early intervention in patients with acute necrotizing pancreatitis (ANP) and evaluate the effect of early intervention on the prognosis of ANP patients.MethodsThe clinical data of patients with ANP who underwent general surgery at Xuanwu Hospital of Capital Medical University from January 1, 2014, to December 31, 2020, were collected retrospectively. The patients were followed-up every 6 months after discharge, and the last follow-up date was June 30, 2021.ResultsA total of 98 patients with ANP were included in the study. They were divided into an early group (n= 43) and a delayed group (n = 55) according to the first percutaneous drainage (PCD) intervention time (≤ 4 weeks or > 4 weeks). Body temperature, inflammatory factor levels, and the number of patients with persistent organ failure (POF) were higher in the early group than in the delayed group. After the minimally invasive intervention, the body temperature and inflammatory factors of the two groups decreased significantly, most patients with POF improved, and the number of patients with reversal of POF in the early group was higher than that in the delayed group. Although the patients in the early group required more surgical intervention than those in the delayed group, there was no significant difference in mortality, incidence of postoperative complications, total length of hospital stay, or operation cost between the two groups. During long-term follow-up, there was no significant difference in the incidence of short-term and long-term complications and overall survival between the two groups.ConclusionsCompared to patients in the delayed group, early intervention did not affect the prognosis of patients with ANP. It may be more suitable for patients with ANP with deterioration [such as POF or infected pancreatic necrosis (IPN)].
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spelling doaj.art-f21c3bc121584b2aa2e96ee68226760b2022-12-22T02:59:12ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2022-04-01910.3389/fsurg.2022.842016842016How to Identify the Indications for Early Intervention in Acute Necrotizing Pancreatitis Patients: A Long-Term Follow-Up StudyJiongdi Lu0Jiongdi Lu1Feng Cao2Feng Cao3Zhi Zheng4Zhi Zheng5Yixuan Ding6Yixuan Ding7Yuanxu Qu8Yuanxu Qu9Wentong Mei10Wentong Mei11Yulin Guo12Yulin Guo13Yu-Lu Feng14Fei Li15Fei Li16Clinical Center of Acute Pancreatitis, Capital Medical University, Beijing, ChinaDepartment of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaClinical Center of Acute Pancreatitis, Capital Medical University, Beijing, ChinaDepartment of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaClinical Center of Acute Pancreatitis, Capital Medical University, Beijing, ChinaDepartment of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaClinical Center of Acute Pancreatitis, Capital Medical University, Beijing, ChinaDepartment of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaClinical Center of Acute Pancreatitis, Capital Medical University, Beijing, ChinaDepartment of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaClinical Center of Acute Pancreatitis, Capital Medical University, Beijing, ChinaDepartment of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaClinical Center of Acute Pancreatitis, Capital Medical University, Beijing, ChinaDepartment of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaDepartment of Pediatric, Chui Yang Liu Hospital Affiliated Tsinghua University, Beijing, ChinaClinical Center of Acute Pancreatitis, Capital Medical University, Beijing, ChinaDepartment of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaAimTo explore the indications for early intervention in patients with acute necrotizing pancreatitis (ANP) and evaluate the effect of early intervention on the prognosis of ANP patients.MethodsThe clinical data of patients with ANP who underwent general surgery at Xuanwu Hospital of Capital Medical University from January 1, 2014, to December 31, 2020, were collected retrospectively. The patients were followed-up every 6 months after discharge, and the last follow-up date was June 30, 2021.ResultsA total of 98 patients with ANP were included in the study. They were divided into an early group (n= 43) and a delayed group (n = 55) according to the first percutaneous drainage (PCD) intervention time (≤ 4 weeks or > 4 weeks). Body temperature, inflammatory factor levels, and the number of patients with persistent organ failure (POF) were higher in the early group than in the delayed group. After the minimally invasive intervention, the body temperature and inflammatory factors of the two groups decreased significantly, most patients with POF improved, and the number of patients with reversal of POF in the early group was higher than that in the delayed group. Although the patients in the early group required more surgical intervention than those in the delayed group, there was no significant difference in mortality, incidence of postoperative complications, total length of hospital stay, or operation cost between the two groups. During long-term follow-up, there was no significant difference in the incidence of short-term and long-term complications and overall survival between the two groups.ConclusionsCompared to patients in the delayed group, early intervention did not affect the prognosis of patients with ANP. It may be more suitable for patients with ANP with deterioration [such as POF or infected pancreatic necrosis (IPN)].https://www.frontiersin.org/articles/10.3389/fsurg.2022.842016/fullacute necrotizing pancreatitispercutaneous drainageinfected pancreatic necrosispersistent organ failurecomplications
spellingShingle Jiongdi Lu
Jiongdi Lu
Feng Cao
Feng Cao
Zhi Zheng
Zhi Zheng
Yixuan Ding
Yixuan Ding
Yuanxu Qu
Yuanxu Qu
Wentong Mei
Wentong Mei
Yulin Guo
Yulin Guo
Yu-Lu Feng
Fei Li
Fei Li
How to Identify the Indications for Early Intervention in Acute Necrotizing Pancreatitis Patients: A Long-Term Follow-Up Study
Frontiers in Surgery
acute necrotizing pancreatitis
percutaneous drainage
infected pancreatic necrosis
persistent organ failure
complications
title How to Identify the Indications for Early Intervention in Acute Necrotizing Pancreatitis Patients: A Long-Term Follow-Up Study
title_full How to Identify the Indications for Early Intervention in Acute Necrotizing Pancreatitis Patients: A Long-Term Follow-Up Study
title_fullStr How to Identify the Indications for Early Intervention in Acute Necrotizing Pancreatitis Patients: A Long-Term Follow-Up Study
title_full_unstemmed How to Identify the Indications for Early Intervention in Acute Necrotizing Pancreatitis Patients: A Long-Term Follow-Up Study
title_short How to Identify the Indications for Early Intervention in Acute Necrotizing Pancreatitis Patients: A Long-Term Follow-Up Study
title_sort how to identify the indications for early intervention in acute necrotizing pancreatitis patients a long term follow up study
topic acute necrotizing pancreatitis
percutaneous drainage
infected pancreatic necrosis
persistent organ failure
complications
url https://www.frontiersin.org/articles/10.3389/fsurg.2022.842016/full
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