Long-term follow-up of patients with necrotizing pancreatitis treated by percutaneous necrosectomy.
OBJECTIVE
The objective of this follow-up study was to assess the long-term outcome of patients with infected necrotizing pancreatitis treated with percutaneous catheter drainage and necrosectomy.


METHODS
Nine patients (median age 44 years, range 19-69) with infected pancreatic necrosis and catheter drainage for initial treatment were evaluated after a median follow-up of 30 months (range 15-52) with respect to quality of life (pain, diarrhea, fat intolerance), morphology and endocrine and exocrine pancreatic function.


RESULTS
At follow-up all 9 patients (100%) were in good general condition with respect to quality of life. Only 2/9 (22%) patients had moderate to marked changes in computed tomography. There was mild to moderate exocrine dysfunction in 5/8 (63%) patients, 2/8 (25%) patients had a severe restriction of the exocrine pancreatic function; in one patient the serum pancreoaryl test was normal. An oral glucose tolerance test was performed in 6/9 patients, with a normal result in 3/6 (50%) patients. 2/6 (33%) patients had an impaired oral glucose tolerance test with metabolic pathogenesis. One patient with diabetes in the oral glucose tolerance test had a preexisting type II diabetes requiring insulin therapy since the onset of acute pancreatitis. In 3/9 (33%) patients an oral glucose tolerance test was not performed due to known preexisting diabetes.


CONCLUSIONS
Percutaneous drainage of infected necrotizing pancreatitis has given good long-term results with regard to quality of life, endocrine and exocrine pancreatic function and may be an alternative to surgical treatment.
Endlicher
E
E
Department of Internal Medicine I, University of Regensburg, D-93042 Regensburg, Germany. esther.endlicher@klinik.uni-regensburg.de
Völk
M
M
Feuerbach
S
S
Schölmerich
J
J
Schäffler
A
A
Messmann
H
H
D000328:Adult; D000368:Aged; D002408:Catheters, Indwelling; D003646:Debridement / Q000379:methods*; D004322:Drainage / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005951:Glucose Tolerance Test; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D010186:Pancreatic Function Tests; D019283:Pancreatitis, Acute Necrotizing / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed