Complications after surgery for necrotising pancreatitis: risk factors and prognosis.
OBJECTIVE
To evaluate risk factors, results of treatment, and prognostic influence of complications on survival from acute necrotising pancreatitis.


METHODS
Retrospective study of prospectively collected data.


METHODS
Tertiary referral centre, Austria.


METHODS
100 consecutive patients operated on for necrotising pancreatitis confirmed by dynamic angio-computed tomography from 1988-1997.


METHODS
77 patients were operated on acutely followed by open management, and in 23 the operations were delayed.


METHODS
Morbidity, mortality, factors predisposing to complications, prognostic effect of complications on survival.


RESULTS
Acute operations, alcoholic origin, APACHE II scores of > or = 10 on admission, and organ dysfunction on admission were independent factors that predisposed patients to complications. Colonic necrosis (n = 17) bleeding (n = 12) and intestinal fistulisation (n = 10) predominated. The overall mortality of complicated pancreatic necrosis was higher among patients admitted with surgical complications than in those who were not, but not significantly so (12/33 compared with 7/44 p = 0.06). Colonic necrosis (mortality 53%, relative risk: 2.45, p = 0.01), however, seemed to be of prognostic relevance.


CONCLUSIONS
Complications are common in severe necrotising pancreatitis leading to organ dysfunction and need for acute operations. Colonic necrosis is an independent prognostic factor for survival.
Kriwanek
S
S
Department of Surgery, Rudolfstiftung Hospital, Vienna, Austria.
Gschwantler
M
M
Beckerhinn
P
P
Armbruster
C
C
Roka
R
R
D000328:Adult; D000368:Aged; D001317:Austria; D002423:Cause of Death; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D019283:Pancreatitis, Acute Necrotizing / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D011379:Prognosis; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate