1. Decreasing use of pancreatic necrosectomy and NSQIP predictors of complications and mortality
- Author
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Amy E. Liepert, George Ventro, Jessica L. Weaver, Allison E. Berndtson, Laura N. Godat, Laura M. Adams, Jarrett Santorelli, Todd W. Costantini, and Jay J. Doucet
- Subjects
Pancreatitis ,Pancreatic necrosectomy ,Infected pancreatic necrosis ,Video-assisted retroperitoneal debridement ,Pancreatic pseudocyst ,Surgery ,RD1-811 ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Abstract Background Surgical pancreatic necrosectomy (SPN) is an option for the management of infected pancreatic necrosis. The literature indicates that an escalating, combined endoscopic, interventional radiology and minimally invasive surgery “step-up” approach, such as video-assisted retroperitoneal debridement, may reduce the number of required SPNs and ICU complications, such as multiple organ failure. We hypothesized that complications for surgically treated severe necrotizing pancreatitis patients decreased during the period of adoption of the “step-up” approach. Methods The American college of surgeons national surgery quality improvement program database (ACS-NSQIP) was used to find SPN cases from 2007 to 2019 in ACS-NSQIP submitting hospitals. Mortality and Clavien-Dindo class 4 (CD4) ICU complications were collected. Predictors of outcomes were identified by univariate and multivariate analyses. Results There were 2457 SPN cases. SPN cases decreased from 0.09% in 2007 to 0.01% in 2019 of NSQIP operative cases (p
- Published
- 2022
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