Observational studyCritical care (London, England)2018
Minimally invasive drainage in critically ill patients with severe necrotizing pancreatitis is associated with better outcomes: an observational study.
Observational study in Critical care (London, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.
- Comparison of early and late drainage interventions in necrotizing pancreatitis: a systematic review and meta-analysis.BMC gastroenterology · 2026Pooled it
- Thoracic epidural analgesia in intensive care unit patients with acute pancreatitis: the EPIPAN multicenter randomized controlled trial.Critical care (London, England) · 2023Trial
- Clinical efficacy and safety analysis of minimally invasive tube placement, aspiration, liquefaction and drainage surgery for patients with cerebral hemorrhage.American journal of translational research · 2025Article
- Minimally invasive step-up surgery demonstrates superior suitability over open surgery in severe acute pancreatitis.American journal of translational research · 2025Article
- Laparoscopic necrosectomy for acute necrotising pancreatitis: Retrospective analysis of a decade-long experience from a tertiary centre.Journal of minimal access surgery · 2024Article
- Surgical management of acute pancreatitis: Historical perspectives, challenges, and current management approaches.World journal of gastrointestinal surgery · 2023Review
- Article
- Factors associated with mortality in patients with infected pancreatic necrosis: the "surgery effect".Updates in surgery · 2020Observational
- Risk factors for mortality in emphysematous pancreatitis.Journal of drug assessment · 2020Article
- Impact of continuous local lavage on pancreatic juice-related postoperative complications: Three case reports.World journal of clinical cases · 2019Article
- Step-up approach for the management of pancreatic necrosis: a review of the literature.Trauma surgery & acute care open · 2019Review
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInfected pancreatic necrosis, which occurs in about 40% of patients admitted for acute necrotizing pancreatitis, requires combined antibiotic therapy and local drainage. Since 2010, drainage by open surgical necrosectomy has been increasingly replaced by less invasive methods such as percutaneous radiological drainage, endoscopic necrosectomy, and laparoscopic surgery, which proved effective in small randomized controlled trials in highly selected patients. Few studies have evaluated minimally invasive drainage methods used under the conditions of everyday hospital practice. The aim of this study was to determine whether, compared with conventional open surgery, minimally invasive drainage was associated with improved outcomes of critically ill patients with infection complicating acute necrotizing pancreatitis.
methodsA single-center observational study was conducted in patients admitted to the intensive care unit for severe acute necrotizing pancreatitis to compare the characteristics, drainage techniques, and outcomes of the 62 patients managed between September 2006 and December 2010, chiefly with conventional open surgery, and of the 81 patients managed between January 2011 and August 2015 after the introduction of a minimally invasive drainage protocol.
resultsSurgical necrosectomy was more common in the early period (74% versus 41%; P <0.001), and use of minimally invasive drainage increased between the early and late periods (19% and 52%, respectively; P <0.001). The numbers of ventilator-free days and catecholamine-free days by day 30 were higher during the later period. The proportions of patients discharged from intensive care within the first 30 days and from the hospital within the first 90 days were higher during the second period. Hospital mortality was not significantly different between the early and late periods (19% and 22%, respectively).
conclusionIn our study, the implementation of a minimally invasive drainage protocol in patients with infected pancreatic necrosis was associated with shorter times spent with organ dysfunction, in the intensive care unit, and in the hospital. Mortality was not significantly different. These results should be interpreted bearing in mind the limitations inherent in the before-after study design.
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