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Management of pancreatic ascites complicating alcoholic chronic pancreatitis
- Source :
- Journal of Visceral Surgery. 158:370-377
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Summary Introduction Pancreatic ascites (PA) is an unusual and little studied complication of chronic alcoholic pancreatitis. Management is complex and is based mainly on empirical data. The aim of this retrospective work was to analyse the management of PA at our centre. Patients and methods A total of 24 patients with PA complicating chronic alcoholic pancreatitis were managed at the Lille University Hospital between 2004 and 2018. Treatment was initially medical and then, in case of failure, interventional (endoscopic, radiological and/or surgical). Data regarding epidemiology, therapeutic and follow-up data were collected retrospectively. Results Twenty-four patients were analysed; median follow-up was 18.5 months [6.75–34.25]. Exclusively medical treatment was effective in three of four patients, but, based on intention to treat, medical therapy alone was effective in only two out of 24 patients. Of 17 patients treated endoscopically, treatment was successful in 15 of them. Of the 15 who underwent surgery, external surgical drainage was effective in 13. Multimodal treatment, initiated after 6.5 days [4–13.5] of medical treatment, was effective in 12 out of 14 patients. In total, 21 patients were successfully treated (87%) with a morbidity rate of 79% and a mortality rate of 12.5% (n = 3). Conclusion PA gives rise to significant morbidity and mortality. Conservative medical treatment has only a limited role. If medical treatment fails, endoscopic and then surgical treatment allow a favourable outcome in more than 80% of patients.
- Subjects :
- medicine.medical_specialty
Pancreatitis, Alcoholic
03 medical and health sciences
0302 clinical medicine
Pancreatic Pseudocyst
Epidemiology
medicine
Humans
Retrospective Studies
Intention-to-treat analysis
Medical treatment
business.industry
Mortality rate
Ascites
General Medicine
medicine.disease
Surgery
Treatment Outcome
030220 oncology & carcinogenesis
Radiological weapon
Pancreatic ascites
Drainage
Pancreatitis
030211 gastroenterology & hepatology
Complication
business
Subjects
Details
- ISSN :
- 18787886
- Volume :
- 158
- Database :
- OpenAIRE
- Journal :
- Journal of Visceral Surgery
- Accession number :
- edsair.doi.dedup.....4952ad21d668fa8f22b192987ff603af