title: A retroperitoneal approach for infected pancreatic necrosis.
abstract: BACKGROUND
  Acute pancreatitis remains associated with a high rate of complication and death. The surgery strategy for proven or suspected infected necrosis is controversial.
  
  
  METHODS
  The present study reviews the medical records of 9,421 patients admitted with the diagnosis of acute pancreatitis from 2002 to 2009.
  
  
  RESULTS
  The medical records of 9,421 admitted patients diagnosed with acute pancreatitis were reviewed. Among the patients, 412 received necrosectomy. Of the 412 that were identified, 108 patients underwent retroperitoneal necrosectomy, whereas the remaining 304 patients received open necrosectomy. The mortality rates were 20.4% (62/304) and 8.3% (9/108), respectively (p = 0.004). The rates of complications in the retroperitoneal group were lower than that in the open group (p < 0.05). The mean lengths of hospital stay and ICU stay after surgery were longer in the open group than those in the retroperitoneal group (48 vs. 30 days; 6 vs. 2 days, p < 0.05). Furthermore, the postoperational days in the hospital and surgical time were also significantly different (30 vs. 12 days; 167 vs. 93 min, p < 0.05).
  
  
  CONCLUSIONS
  A retroperitoneal pancreatic necrosectomy approach reduced the rate of complications and death among patients with infected necrosis, compared with open necrosectomy.
authors.affiliation: Hepato-Bilio-Pancreatic Surgery, West China Hospital, Sichuan University, Sichuan Province, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Guo
authors.forename: Huimin
authors.initials: H
authors.lastname: Lu
authors.forename: Weiming
authors.initials: W
authors.lastname: Hu
authors.forename: Zhaoda
authors.initials: Z
authors.lastname: Zhang
mesh_terms: D000038:Abscess / Q000150:complications / Q000401:mortality / Q000601:surgery*; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D010180:Pancreatectomy / Q000379:methods*; D019283:Pancreatitis, Acute Necrotizing / Q000150:complications / Q000401:mortality / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome