This study aimed to evaluate the surgical treatment of acute pancreatitis in Italy and to assess compliance with international guidelines.

Objective: This study aimed to evaluate the surgical treatment of acute pancreatitis in Italy and to assesscompliance with international guidelines.Methods: A series of 1173 patients in 56 hospitals were prospectively enrolled and their data analysed.Results: Twenty-nine patients with severe pancreatitis underwent surgical intervention. Necrosectomywas performed in 26 patients, associated with postoperative lavage in 70% of cases. A feeding jejunostomywas added in 37% of cases. Mortality was 21%. Of the patients with mild pancreatitis, 714patients with a biliary aetiology were evaluated. Prophylactic treatment of relapses was carried out in 212patients (36%) by cholecystectomy and in 161 using a laparoscopic approach. Preoperative endoscopicretrograde cholangiopancreatography was associated with cholecystectomy in 83 patients (39%). Fortysevenpatients (22%) were treated at a second admission, with a median delay of 31 days from the onsetof pancreatitis. Eighteen patients with severe pancreatitis underwent cholecystectomy 37.9 days after thefirst admission. There were no deaths.Discussion: The results indicate poor compliance with published guidelines. In severe pancreatitis, earlysurgical intervention is frequently performed and enteral feeding is seldom used. Only a small number ofpatients with mild biliary pancreatitis undergo definitive treatment (i.e. cholecystectomy) within 4 weeksof the onset of pancreatitis.

Surgical management of acute pancreatitis in Italy: lessons from a prospective multicentre study. HPB (Oxford), 2010; 12(9): 597-604.

BASSI, Claudio;FRULLONI, Luca;GABBRIELLI, Armando;CAVALLINI, Giorgio;
2010-01-01

Abstract

Objective: This study aimed to evaluate the surgical treatment of acute pancreatitis in Italy and to assesscompliance with international guidelines.Methods: A series of 1173 patients in 56 hospitals were prospectively enrolled and their data analysed.Results: Twenty-nine patients with severe pancreatitis underwent surgical intervention. Necrosectomywas performed in 26 patients, associated with postoperative lavage in 70% of cases. A feeding jejunostomywas added in 37% of cases. Mortality was 21%. Of the patients with mild pancreatitis, 714patients with a biliary aetiology were evaluated. Prophylactic treatment of relapses was carried out in 212patients (36%) by cholecystectomy and in 161 using a laparoscopic approach. Preoperative endoscopicretrograde cholangiopancreatography was associated with cholecystectomy in 83 patients (39%). Fortysevenpatients (22%) were treated at a second admission, with a median delay of 31 days from the onsetof pancreatitis. Eighteen patients with severe pancreatitis underwent cholecystectomy 37.9 days after thefirst admission. There were no deaths.Discussion: The results indicate poor compliance with published guidelines. In severe pancreatitis, earlysurgical intervention is frequently performed and enteral feeding is seldom used. Only a small number ofpatients with mild biliary pancreatitis undergo definitive treatment (i.e. cholecystectomy) within 4 weeksof the onset of pancreatitis.
2010
Aged; Biliary Tract Diseases; Chi-Square Distribution; Cholangiopancreatography, Endoscopic Retrograde; Cholecystectomy, Laparoscopic; Female; Guideline Adherence; Humans; Italy; Male; Pancreatitis; Pancreatitis, Acute Necrotizing; Pancreatitis, Alcoholic; Practice Guidelines as Topic; Prospective Studies; Risk Assessment; Risk Factors; Severity of Illness Index; Time Factors; Treatment Outcome; Cholecystectomy; Jejunostomy; Pancreatectomy; Practice Patterns, Physicians'
surgery; acute pancreatitis; biliary
This study aimed to evaluate the surgical treatment of acute pancreatitis in Italy and to assess compliance with international guidelines.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11562/391076
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