Pancreatic necrosectomy: The factors related to morbidity, mortality and cost
| Autor: | N Chaudhary, D S Mitra, V Varma, S Kapoor, A Yadav, N Mehta, V Kumaran, S Nundy |
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| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: | |
| Zdroj: | Current Medicine Research and Practice, Vol 2, Iss 6, Pp 326-331 (2012) |
| Druh dokumentu: | article |
| ISSN: | 2352-0817 2352-0825 |
| Popis: | Background: Necrosectomy for acute pancreatitis is associated with a substantial morbidity and mortality and a high cost of treatment. Although many studies from Western countries have examined the individual factors associated with complications, there are few reports from developing countries, especially those which have also considered the expenditure incurred by patients who have undergone operations for pancreatitis. We aimed to investigate these aspects. Patients and methods: We retrospectively analysed, from a prospectively collected database, the records of all patients who had undergone pancreatic necrosectomy (PN) in our department between January 2007 and July 2011. Results: One hundred and one patients had a PN during the study period. There were 85 (84%) men and 16 women who had a mean age of 39±13.6 years (range: 17–84 years). The most common cause of pancreatitis was biliary disease (26%) and excessive alcohol intake (14%). No obvious cause was found in the remaining 53 (52%) patients. PN was done after a median duration of 38 days (IQR: 25–51.5 days) from the onset of symptoms. The 30-day and in-hospital mortality was 21.7% (22 patients). The median duration of hospital stay was 30 days (IQR: 18–45 days) with the mean cost of treatment being Rs 7,73,897 (SD: Rs 6,05,703, range: Rs 2,04,533–27,64,985). Conclusions: PN for acute necrotizing pancreatitis (ANP) carries a high morbidity and mortality and imposes a huge financial burden on the patient and the healthcare system. Preoperative renal dysfunction and intensive care unit (ICU) stay, and prolonged postoperative ventilatory and inotropic support are associated with increased mortality. Idiopathic pancreatitis, preoperative percutaneous drainage (PCD) and ICU stay are associated with increased costs. These data may be helpful in informing the patients’ relatives of the likely clinical and financial implications of treating this serious disease. |
| Databáze: | Directory of Open Access Journals |
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