CHARLOTTE, N.C.—Endoscopic management of necrotizing pancreatitis alone or with percutaneous drainage of symptomatic pancreatic fluid collections has multiple advantages over surgery or percutaneous drainage alone, with no increase in complications, according to a recent study.
“The main findings in terms of outcomes favored the endoscopy group: significantly shorter hospital stay, significantly less risk of needing transfer to the intensive care unit and significantly lower 90-day mortality rate,” said investigator Vibhu Chittajallu, MD, a second-year gastroenterology fellow at Case Western Reserve University and University Hospitals Cleveland Medical Center.
To compare endoscopic drainage and/or radiologically guided percutaneous drainage and surgical approaches in this setting, Dr. Chittajallu and his co-investigators analyzed patients seen at their institution from 2009 to 2019. They followed the patients for a median of 17 months, comparing the three approaches among 318 patients with necrotizing pancreatitis complicated by pancreatic fluid collection (PFC): endoscopy alone or in combination with interventional radiologically guided percutaneous drainage (IR/PERC) (n=229), surgery alone (n=30) or IR/PERC alone (n=59).