Endoscopy May Be Better Than Surgery for Severe Pancreatic Infection
TUESDAY March 13, 2012 -- Patients with infected severe pancreatitis fare better if they undergo a less invasive endoscopic procedure rather than surgery, a new study finds.
The small, preliminary trial of 20 patients with infected necrotizing pancreatitis found that those who underwent endoscopic transgastric necrosectomy (removal of the pancreatic tissue) were less likely to die or experience major complications than those who had surgical necrosectomy.
Five of the 20 patients died -- 10 percent of those in the endoscopy group compared with 40 percent of those in the surgery group. All deaths were caused by multiple organ failure.
Major complications occurred in 20 percent of patients in the endoscopy group and 80 percent of those in the surgery group, according to the researchers.
"Acute pancreatitis is a common and potentially lethal disorder. In the United States alone, more than 50,000 patients are admitted with acute pancreatitis each year," wrote Dr. Olaf Bakker, of University Medical Center Utrecht in the Netherlands, and colleagues. "One of the most dreaded complications in these patients is infected necrotizing pancreatitis that leads to sepsis and is often followed by multiple organ failure."
Most patients with infected necrotizing pancreatitis require necrosectomy. Surgical necrosectomy causes inflammation and has a high complication rate, the researchers said in a journal news release.
Endoscopic transgastric necrosectomy is a new technique that is performed with the patient under conscious sedation, instead of general anesthesia. The procedure can reduce the risk of inflammation and complications such as multiple organ failure, according to the study authors.
The study appears in the March 14 issue of the Journal of the American Medical Association.
The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about pancreatitis.
Posted: March 2012
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