Perioperative nursing management in video-assisted retroperitoneal debridement for severe acute pancreatitis with infected peripancreatic necrosis: a retrospective single-center case series of 41 patients.

Background: Severe acute pancreatitis (SAP) complicated by infected peripancreatic necrosis (IPN) represents a life-threatening condition. Video-assisted retroperitoneal debridement (VARD) is a preferred minimally invasive surgical approach for managing this disease; however, detailed reports on the perioperative nursing care for this procedure remain limited. This study summarizes the nursing experience and management strategies in 41 patients who underwent VARD at our institution. Materials and methods: We conducted a retrospective, single-center, uncontrolled case series of 41 consecutive SAP patients with IPN who underwent VARD between July 2024 and June 2025. We implemented a standardized perioperative nursing protocol that included the following components: 1) preoperative preparation (multidisciplinary team, patient assessment, organ support, multimodal analgesia, emergency plan); 2) intraoperative nursing care (instruments coordination, VARD assistance, positioning, sterile field); and 3) postoperative management (individualized drainage, fluid therapy, stepwise nutrition, complication prevention). Patient characteristics, surgical and nursing-sensitive outcomes were recorded. Results: The cohort comprised 30 males and 11 females, with a mean age of 52.9 ± 10.6 years. The mean operative time was 133.9 ± 26.1 min, with mean blood loss 92.0 ± 37.6 mL and no intraoperative transfusions. Six patients (14.6%; 95% CI 6.9%-28.1%) required a second debridement, of whom two (4.9%; 95% CI 1.3%-16.7%) underwent a third procedure. Postoperative intra-abdominal hemorrhage occurred in one patient (2.4%; 95% CI 0.4%-14.2%). No new-onset organ failure or mortality occurred. The mean lengths of ICU stay and hospital stay were 10.1 ± 4.4 days (median 9.0 days, IQR 7.0-11.0) and 34.9 ± 7.1 days (median 34.0 days, IQR 29.0-39.5), respectively. Nursing-sensitive complications occurred at low rates in this cohort, including no pressure injuries, and low incidences of unplanned drain dislodgement, Catheter-related bloodstream infection (CRBSI), and Catheter-associated urinary tract infection (CAUTI). Conclusions: In this retrospective, single-center, uncontrolled case series, the implemented perioperative nursing protocol was feasible and associated with acceptable perioperative outcomes, with low rates of nursing-sensitive complications. Owing to the study design, causal conclusions cannot be drawn. Future prospective, controlled studies are needed to validate these findings.