Volume 7 Issue 3
May  2016
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Meng JIN, Hui-min ZHANG, Bo LU, Dong WU, Jia-ming QIAN, Hong YANG. Clinical Features of Acute Pancreatitis with Acute Necrotic Collection and Walled-off Pancreatic Necrosis[J]. Medical Journal of Peking Union Medical College Hospital, 2016, 7(3): 180-184. doi: 10.3969/j.issn.1674-9081.2016.03.004
Citation: Meng JIN, Hui-min ZHANG, Bo LU, Dong WU, Jia-ming QIAN, Hong YANG. Clinical Features of Acute Pancreatitis with Acute Necrotic Collection and Walled-off Pancreatic Necrosis[J]. Medical Journal of Peking Union Medical College Hospital, 2016, 7(3): 180-184. doi: 10.3969/j.issn.1674-9081.2016.03.004

Clinical Features of Acute Pancreatitis with Acute Necrotic Collection and Walled-off Pancreatic Necrosis

doi: 10.3969/j.issn.1674-9081.2016.03.004
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  • Corresponding author: YANG Hong   Tel: 010-69155014, E-mail: hongy72@163.com
  • Received Date: 2016-01-16
  • Publish Date: 2016-05-30
  •   Objective  To evaluate the clinical features and explore the prognostic factors of acute necrotic collection (ANC) and walled-off pancreatic necrosis (WOPN) following acute pancreatitis.  Methods  A retrospective study was conducted to analyze the clinical data of 164 patients with moderate to severe acute pancreatitis treated in Peking Union Medical College Hospital from October 2013 to October 2015. Clinical and laboratory indexes were compared between ANC and non-ANC, WOPN and non-WOPN patients.  Results  The proportions of systemic complications and infection were significantly higher in patients with ANC following acute pancreatitis (respiratory failure 47.1% vs. 30.2%, cardiovascular failure 14.7% vs. 5.2%, renal failure 38.2% vs. 15.6%, infection 19.1% vs. 6.3%, all P < 0.05). Within 48 hours of admission, higher levels of heart rate, high-sensitive C-reactive protein, glucose, serum creatinine, urea, and lower level of PaO2 were observed in patients with ANC compared with patients without ANC (all P < 0.05). Among ANC patients, higher proportions of infection, intervention therapy and surgery were found in patients with WOPN (infection 40.7% vs. 4.9%, P < 0.001; intervention 29.6% vs. 7.3%, P=0.020; surgery 22.2% vs. 0, P=0.003); these patients also had longer hospital stay[29.0(15.0, 56.0)d vs. 13.0(4.5, 26.3)d, P=0.005] and higher total costs[72 818.3(27 805.1, 168 932.9)RMB vs. 28 155.2(6057.6, 51 259.1)RMB, P=0.015]. Within the first 1-2 weeks after onset, a higher temperature, heart rate, breathe rate, counts of white blood cells, counts of neutrophils, and a lower level of blood calcium were shown in patients with WOPN compared with patients whose necrotic materials were absorbed.  Conclusions  ANC and WOPN are associated with more severe clinical manifestations, higher risk of infection, higher proportion of intervention therapy and surgery, longer hospital stay and increased cost. Laboratory tests are useful in the prediction and monitoring of local complications in acute pancreatitis.
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  • [1] Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis—2012: revision of the Atlanta classification and definitions by international consensus[J]. Gut, 2013, 62: 102-111. doi:  10.1136/gutjnl-2012-302779
    [2] Mier J, Leon EL, Castillo A, et al. Early versus late necrosectomy in severe necrotizing pancreatitis[J]. Am J Surg, 1997, 173: 71-75. doi:  10.1016/S0002-9610(96)00425-4
    [3] Stamatakos M, Stefanaki C, Kontzoglou K, et al. Walled-off pancreatic necrosis[J]. World J Gastroenterol, 2010, 16: 1707-1712. doi:  10.3748/wjg.v16.i14.1707
    [4] Gardner TB, Chahal P, Papachristou GI, et al. A comparison of direct endoscopic necrosectomy with transmural endoscopic drainage for the treatment of walled-off pancreatic necrosis[J]. Gastrointest Endosc, 2009, 69: 1085-1094. doi:  10.1016/j.gie.2008.06.061
    [5] Varadarajulu S, Phadnis MA, Christein JD, et al. Multiple transluminal gateway technique for EUS-guided drainage of symptomatic walled-off pancreatic necrosis[J]. Gastrointest Endosc, 2011, 74: 74-80. doi:  10.1016/j.gie.2011.03.1122
    [6] Ramia JM, De La Plaza R, Quinones-Sampedro JE, et al. Walled-off pancreatic necrosis[J]. Neth J Med, 2012, 70: 168-171. https://www.ncbi.nlm.nih.gov/pubmed/20380001
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