title: Five-year cohort study of open pancreatic necrosectomy for necotizing pancreatitis suggests it is a safe and effective operation.
abstract: BACKGROUND
  Despite advances in the management of necrotizing pancreatitis, open necrosectomy remains an important management option for necrotizing pancreatitis, and patients undergoing necrosectomy suffer significant morbidity and mortality. The aim of this study was to report the outcomes of open necrosectomy from a recent large cohort of patients with necrotizing pancreatitis.
  
  
  METHODS
  Data are reported from a cohort of 276 consecutive patients with necrotizing pancreatitis who underwent open surgical debridement. Nutritional status, nutritional methods, bleeding, infection, demarcation of necrotic tissues, and time from onset of disease were scored. Scores ≥ 10 were considered as an indication for debridement.
  
  
  RESULTS
  One hundred sixty-two (58.7%) and 52 (18.8%) patients underwent minimally invasive peritoneal and retroperitoneal drainage, respectively, before necrosectomy. Median delay from disease onset to debridement was 48 days. Fifty-five patients (19.9%) underwent more than one operation; 352 operations were performed in total. There were 17 deaths (6.2%) postoperatively.
  
  
  CONCLUSIONS
  This study demonstrated the results for open debridement in a recent large cohort of patients. Although minimally invasive necrosectomy has been developed in recent years, open necrosectomy remains an important approach for the debridement of necrotizing pancreatitis effectively and safely.
authors.affiliation: Pancreatic Disease Institute, Department of General Surgery, Union Hospital, HUST, Wuhan, China.
authors.forename: Shanmiao
authors.initials: S
authors.lastname: Gou
authors.forename: Jiongxin
authors.initials: J
authors.lastname: Xiong
authors.forename: Heshui
authors.initials: H
authors.lastname: Wu
authors.forename: Feng
authors.initials: F
authors.lastname: Zhou
authors.forename: Jing
authors.initials: J
authors.lastname: Tao
authors.forename: Tao
authors.initials: T
authors.lastname: Liu
authors.forename: Chunyou
authors.initials: C
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D003646:Debridement / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000379:methods*; D019283:Pancreatitis, Acute Necrotizing / Q000401:mortality / Q000601:surgery*; D011183:Postoperative Complications; D012086:Reoperation; D016896:Treatment Outcome