ArticleWorld journal of emergency surgery : WJES2021
Who would benefit from open abdomen in severe acute pancreatitis?-a matched case-control study.
Article in World journal of emergency surgery : WJES, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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Who cites it
4 citing papers in PubMed, 11 citations in OpenAlex.
- Minimally invasive step-up surgery demonstrates superior suitability over open surgery in severe acute pancreatitis.American journal of translational research · 2025Article
- Surgical decompression for the management of abdominal compartment syndrome with severe acute pancreatitis: A narrative review.World journal of gastrointestinal surgery · 2023Review
- The open abdomen in trauma, acute care, and vascular and endovascular surgery: comprehensive, expert, narrative review.BJS open · 2023Review
- Intra-Abdominal Hypertension: A Systemic Complication of Severe Acute Pancreatitis.Medicina (Kaunas, Lithuania) · 2022Review
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSelection of patients for open abdomen (OA) treatment in severe acute pancreatitis (SAP) is challenging. Treatment related morbidity and risk of adverse events are high; however, refractory abdominal compartment syndrome (ACS) is potentially lethal. Factors influencing the decision to initiate OA treatment are clinically important. We aimed to study these factors to help understand what influences the selection of patients for OA treatment in SAP.
methodsA single center study of patients with SAP that underwent OA treatment compared with conservatively treated matched controls.
resultsWithin study period, 47 patients treated with OA were matched in a 1:1 fashion with conservatively treated control patients. Urinary output under 20 ml/h (OR 5.0 95% CI 1.8-13.7) and ACS (OR 4.6 95% CI 1.4-15.2) independently associated with OA treatment. Patients with OA treatment had significantly more often visceral ischemia (34%) than controls (6%), P = 0.002. Mortality among patients with visceral ischemia was 63%. Clinically meaningful parameters predicting developing ischemia were not found. OA treatment associated with higher overall 90-day mortality rate (43% vs 17%, P = 0.012) and increased need for necrosectomy (55% vs 21%, P = 0.001). Delayed primary fascial closure was achieved in 33 (97%) patients that survived past OA treatment.
conclusionDecreased urine output and ACS were independently associated with the choice of OA treatment in patients with SAP. Underlying visceral ischemia was strikingly common in patients undergoing OA treatment, but predicting ischemia in these patients seems difficult.
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