Pancreatic Pseudocysts: Is Delayed Surgical Intervention Associated with Adverse Outcomes? |
| |
Authors: | Kaori Ito Alexander Perez Hiromichi Ito Edward E Whang |
| |
Institution: | (1) Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA |
| |
Abstract: | Background Nonsurgical interventions are increasingly applied for pancreatic pseudocysts. We hypothesized that surgical therapy applied
after failure of percutaneous or endoscopic therapies for pseudocysts is associated with poorer outcomes than cases in which
surgery is the initial intervention.
Materials and methods Medical records of all 284 patients admitted with pancreatic pseudocysts at our institution (1/1990–9/2005) were analyzed.
Forty-six patients underwent surgery as the initial intervention (group A). Among 162 patients who underwent percutaneous
or endoscopic drainage as the initial intervention, 75 patients required subsequent surgery after failure of nonsurgical intervention
(group B).
Results Groups were comparable in demographic variables and in location, number, and size of pseudocysts. Forty-two percent of group
B patients developed infection within their pseudocysts after their nonsurgical interventions. Compared to group A patients,
group B patients had higher rates of overall perioperative morbidity (47.8% vs 73.3%, p = 0.01) and postoperative readmission (24.0% vs 44.7%, p = 0.04). Five (6.7%) group B patients died in the perioperative period; there were no perioperative deaths among group A
patients.
Conclusion Delayed surgical intervention for pancreatic pseudocysts is associated with higher incidences of postoperative complications,
readmission, morbidity, and mortality. The increasing application of nonsurgical interventions needs to be reevaluated.
This study was presented at the American Hepato-Pancreato-Biliary Association 2007 Annual Meeting on April 21, 2007 at Las
Vegas, Nevada. |
| |
Keywords: | Pancreatic pseudocyst Pancreatitis Pancreatic surgery |
本文献已被 SpringerLink 等数据库收录! |
|