ArticleLangenbeck's archives of surgery2024
Endoscopic and surgical treatment of necrotizing pancreatitis-a comparison of short- and long-term outcome.
Article in Langenbeck's archives of surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Microbial spectrum and antimicrobial resistance are associated with outcomes after endoscopic ultrasound-guided therapy of pancreatic fluid collections.Scientific reports · 2026Article
- Guidelines for endoscopic treatment of postinflammatory pancreatic and peripancreatic fluid collections. Recommendations of the Endoscopic Surgery Section of the Association of Polish Surgeons, the Endoscopy Section of the Polish Society of Gastroenterology, the Polish Pancreatic Club, the Laparoscopic and Robotic Surgery Section of the Association of Polish Surgeons, and the Pancreatic Surgery Section of the Association of Polish Surgeons; formulated by an expert panel led by Prof. Mateusz Jagielski, MD, PhD.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2025Review
- Minimally invasive approach versus open approach in the management of necrotizing acute pancreatitis: A systematic review and meta-analysis.Annals of hepato-biliary-pancreatic surgery · 2025Review
- Diagnostic and therapeutic management of severe acute pancreatitis. Evidence based medicine (EBM) clinical practice guidelines.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2025Article
- Early versus delayed necrosectomy in pancreatic necrosis: A population-based cohort study on readmission, healthcare utilization, and in-hospital mortality.World journal of methodology · 2024Article
- Minimally invasive surgery compared to endoscopic intervention for treating infected pancreatic necrosis. A meta-analysis.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2024Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcute necrotizing pancreatitis is still related to high morbidity and mortality rates. Minimal-invasive treatment options, such as endoscopic necrosectomy, may decrease peri-interventional morbidity and mortality. This study aims to compare the initial operative with endoscopic treatment on long-term parameters, such as endocrine and exocrine functionality, as well as mortality and recurrence rates.
methodsWe included 114 patients, of whom 69 were treated with initial endoscopy and 45 by initial surgery. Both groups were further assessed for peri-interventional and long-term parameters.
resultsIn the post-interventional phase, patients in the group of initial surgical treatment (IST) showed significantly higher rates of renal insufficiency (p < 0.001) and dependency on invasive ventilation (p < 0.001). The in-house mortality was higher in the surgical group, with 22% vs. 10.1% in the group of patients following initial endoscopic treatment (IET; p = 0.077). In long-term follow-up, the overall mortality was 45% for IST and 31.3% for IET (p = 0.156). The overall in-hospital stay and intensive care unit (ICU) stay were significantly shorter after IET (p < 0.001). In long-term follow-up, the prevalence of endocrine insufficiency was 50% after IST and 61.7% after IET (p = 0.281). 57.1% of the patients following IST and 16.4% of the patients following IET had persistent exocrine insufficiency at that point (p = < 0.001). 8.9% of the IET and 27.6% of the IST patients showed recurrence of acute pancreatitis (p = 0.023) in the long-term phase.
conclusionIn our cohort, an endoscopic step-up approach led to a reduced in-hospital stay and peri-interventional morbidity. The endocrine function appeared comparable in both groups, whereas the exocrine insufficiency seemed to recover in the endoscopic group in the long-term phase. These findings advocate for a preference for endoscopic treatment of acute necrotizing pancreatitis whenever feasible.
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