Endoscopic ultrasound criteria to predict the need for intervention in pancreatic necrosis.

Abstract:

BACKGROUND:The natural course and treatment strategies for asymptomatic or oligosymptomatic pancreatic necrosis are still poorly defined. The aim of this retrospective study was to establish criteria for the need of intervention in patients with pancreatic necrosis. METHODS:A total of 31 consecutive patients (18 male, median age 58 yrs.) diagnosed with pancreatic necrosis by endoscopic ultrasound, in whom a decision for initial conservative treatment was made, were followed for the need of interventions such as endoscopic or surgical intervention, or death. RESULTS:After a median follow-up of 243 days, 21 patients remained well without intervention and in 10 patients an endpoint event occurred. In a multivariate logistic regression analysis of the clinical and endosonographic parameters, liquid content was the single independent predictor for intervention (p = 0.0006). The presence of high liquid content in the pancreatic necrosis resulted in a 64% predicted endpoint risk as compared to 2% for solid necrosis. CONCLUSIONS:Pancreatic necrotic cavities with high liquid content are associated with a high risk of complications. Therefore, close clinical monitoring is needed and early elective intervention might be considered in these patients.

journal_name

BMC Gastroenterol

journal_title

BMC gastroenterology

authors

Jürgensen C,Arlt A,Neser F,Fritscher-Ravens A,Stölzel U,Hampe J

doi

10.1186/1471-230X-12-48

subject

Has Abstract

pub_date

2012-05-14 00:00:00

pages

48

issn

1471-230X

pii

1471-230X-12-48

journal_volume

12

pub_type

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