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Site and size of extrapancreatic necrosis are associated with clinical outcomes in patients with acute necrotizing pancreatitis.
Pancreatology 2020; 20(1):9-15P

Abstract

BACKGROUND

The site and size of extrapancreatic necrosis (EPN) as assessed on computed tomography may influence the severity of acute necrotizing pancreatitis (ANP). The objective of the study was to evaluate the impact of site and size of EPN on the clinical outcomes in patients with acute necrotizing pancreatitis (ANP).

METHOD AND MATERIALS

This retrospective study comprised of consecutive patients with ANP who were admitted between January 2017 and March 2019. Patients in whom the initial contrast enhanced CT showed EPN were eligible for inclusion. The site, volume and maximum dimension of EPN were recorded. The severity of AP and modified CT severity index (MCTSI) was calculated. Clinical outcomes were recorded.

RESULTS

A total of 119 patients (mean age, 37.56 years, 91 males) were included. There was a significant association between the location of EPN and the outcome parameters. The left posterior pararenal collections were significantly associated with mortality (P = 0.041), left paracolic gutter collections with the length of hospitalisation (LOH) (P = 0.014), and right paracolic gutter and mesenteric collections with the intensive care unit (ICU) stay (P = 0.024, and P = 0.021, respectively). There was a significant correlation between the volume and the maximum dimension of collection with LOH and ICU stay. The area under the receiver operating characteristic curve for volume, maximum dimension and MCTSI for predicting death was 0.724 (95% CI, 0.612-0.837), 0.644 (95% CI, 0.516-0.772) and 0.574 (95% CI, 0.452-0.696), respectively.

CONCLUSION

The site and size of EPN provide reliable and objective information for assessing clinical outcomes in patients with ANP.

Authors+Show Affiliations

Department of Gastroenterology Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India. Electronic address: Pankajgupta959@gmail.com.Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.Department of Gastroenterology Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.Department of Gastroenterology Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.Department of Gastroenterology Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.Department of Gastroenterology Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.Department of Gastroenterology Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.Department of Gastroenterology Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.Department of Gastroenterology Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31780286

Citation

Gupta, Pankaj, et al. "Site and Size of Extrapancreatic Necrosis Are Associated With Clinical Outcomes in Patients With Acute Necrotizing Pancreatitis." Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.], vol. 20, no. 1, 2020, pp. 9-15.
Gupta P, Rana P, Bellam BL, et al. Site and size of extrapancreatic necrosis are associated with clinical outcomes in patients with acute necrotizing pancreatitis. Pancreatology. 2020;20(1):9-15.
Gupta, P., Rana, P., Bellam, B. L., Samanta, J., Mandavdhare, H., Sharma, V., ... Kochhar, R. (2020). Site and size of extrapancreatic necrosis are associated with clinical outcomes in patients with acute necrotizing pancreatitis. Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.], 20(1), pp. 9-15. doi:10.1016/j.pan.2019.11.010.
Gupta P, et al. Site and Size of Extrapancreatic Necrosis Are Associated With Clinical Outcomes in Patients With Acute Necrotizing Pancreatitis. Pancreatology. 2020;20(1):9-15. PubMed PMID: 31780286.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Site and size of extrapancreatic necrosis are associated with clinical outcomes in patients with acute necrotizing pancreatitis. AU - Gupta,Pankaj, AU - Rana,Pratyaksha, AU - Bellam,Balaji L, AU - Samanta,Jayanta, AU - Mandavdhare,Harshal, AU - Sharma,Vishal, AU - Sinha,Saroj K, AU - Dutta,Usha, AU - Kochhar,Rakesh, Y1 - 2019/11/20/ PY - 2019/10/06/received PY - 2019/11/17/revised PY - 2019/11/19/accepted PY - 2019/11/30/pubmed PY - 2019/11/30/medline PY - 2019/11/30/entrez KW - Acute pancreatitis KW - Computed tomography KW - Extrapancreatic necrosis KW - Pancreatic collection SP - 9 EP - 15 JF - Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] JO - Pancreatology VL - 20 IS - 1 N2 - BACKGROUND: The site and size of extrapancreatic necrosis (EPN) as assessed on computed tomography may influence the severity of acute necrotizing pancreatitis (ANP). The objective of the study was to evaluate the impact of site and size of EPN on the clinical outcomes in patients with acute necrotizing pancreatitis (ANP). METHOD AND MATERIALS: This retrospective study comprised of consecutive patients with ANP who were admitted between January 2017 and March 2019. Patients in whom the initial contrast enhanced CT showed EPN were eligible for inclusion. The site, volume and maximum dimension of EPN were recorded. The severity of AP and modified CT severity index (MCTSI) was calculated. Clinical outcomes were recorded. RESULTS: A total of 119 patients (mean age, 37.56 years, 91 males) were included. There was a significant association between the location of EPN and the outcome parameters. The left posterior pararenal collections were significantly associated with mortality (P = 0.041), left paracolic gutter collections with the length of hospitalisation (LOH) (P = 0.014), and right paracolic gutter and mesenteric collections with the intensive care unit (ICU) stay (P = 0.024, and P = 0.021, respectively). There was a significant correlation between the volume and the maximum dimension of collection with LOH and ICU stay. The area under the receiver operating characteristic curve for volume, maximum dimension and MCTSI for predicting death was 0.724 (95% CI, 0.612-0.837), 0.644 (95% CI, 0.516-0.772) and 0.574 (95% CI, 0.452-0.696), respectively. CONCLUSION: The site and size of EPN provide reliable and objective information for assessing clinical outcomes in patients with ANP. SN - 1424-3911 UR - https://www.unboundmedicine.com/medline/citation/31780286/Site_and_size_of_extrapancreatic_necrosis_are_associated_with_clinical_outcomes_in_patients_with_acute_necrotizing_pancreatitis L2 - https://linkinghub.elsevier.com/retrieve/pii/S1424-3903(19)30791-4 DB - PRIME DP - Unbound Medicine ER -