Biliary versus alcohol-related infected pancreatic necrosis: similarities and differences in the follow-up.
OBJECTIVE
Infected pancreatic necrosis (IPN) is a serious complication of acute pancreatitis. Data concerning survivors' quality of life and pancreatic functions are scarce. Follow-up of the patients with alcohol and biliary etiology of IPN treated with open necrosectomy was performed.


METHODS
Twenty-eight survivors after operative treatment (Bradley procedure) of IPN were followed up 24 to 96 months after discharge from the hospital (10 biliary and 18 alcohol patients). Their exocrine and endocrine pancreatic functions and quality of life (Functional Assessment of Chronic Illness Therapy scale) were evaluated. Pancreatic tissue remaining after necrosectomy was visualized by use of contrast-enhanced computed tomography (CT).


RESULTS
In 44.4% of alcohol-induced IPN patients, the presence of the whole pancreas was shown on the follow-up CT, contrary to the biliary group, where the partial lack of the pancreas was observed in all cases. Pancreatic tissue calcifications were present on CT in 8 patients of alcohol-induced acute pancreatitis group only. Median stool elastase 1 concentrations were 318.1 U/mL in the biliary group and 238.3 U/mL in the alcohol-induced group (not significant). The Functional Assessment of Chronic Illness Therapy scale showed significantly higher social/family and emotional well-being in patients with biliary acute necrotizing pancreatitis.


CONCLUSIONS
Patients after alcohol-induced IPN had lower quality of life compared with biliary etiology. Biliary and alcohol-induced IPN patients after surgical treatment have nonsignificant differences of endocrine and exocrine pancreatic functions.
Reszetow
Jacek
J
Department of General, Endocrine, and Transplant Surgery, Medical University of Gdańsk, Poland. jreszet@amg.gda.pl
Hać
Stanisław
S
Dobrowolski
Sebastian
S
Stefaniak
Tomasz
T
Wajda
Zdzisław
Z
Gruca
Zbigniew
Z
Sledziński
Zbigniew
Z
Studniarek
Michał
M
D000208:Acute Disease; D000328:Adult; D000368:Aged; D001660:Biliary Tract Diseases / Q000150:complications / Q000601:surgery; D001786:Blood Glucose / Q000032:analysis; D002114:Calcinosis / Q000453:epidemiology / Q000209:etiology; D010188:Exocrine Pancreatic Insufficiency / Q000453:epidemiology / Q000209:etiology; D005243:Feces / Q000201:enzymology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D010179:Pancreas / Q000000981:diagnostic imaging / Q000503:physiopathology; D010180:Pancreatectomy / Q000379:methods / Q000706:statistics & numerical data; D010196:Pancreatic Elastase / Q000032:analysis; D019283:Pancreatitis, Acute Necrotizing / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D019512:Pancreatitis, Alcoholic / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D011788:Quality of Life; D011859:Radiography; D012720:Severity of Illness Index; D016717:Sphincterotomy, Endoscopic / Q000706:statistics & numerical data; D017741:Survivors / Q000523:psychology / Q000706:statistics & numerical data
D001786:Blood Glucose; D010196:Pancreatic Elastase