TUESDAY, March 13 (HealthDay News) -- Patients with infected
severe pancreatitis fare better if they undergo a less invasive
endoscopic procedure rather than surgery, a new study finds.
The small, preliminary trial of 20 patients with infected
necrotizing pancreatitis found that those who underwent endoscopic
transgastric necrosectomy (removal of the pancreatic tissue) were
less likely to die or experience major complications than those who
had surgical necrosectomy.
Five of the 20 patients died -- 10 percent of those in the
endoscopy group compared with 40 percent of those in the surgery
group. All deaths were caused by multiple organ failure.
Major complications occurred in 20 percent of patients in the
endoscopy group and 80 percent of those in the surgery group,
according to the researchers.
"Acute pancreatitis is a common and potentially lethal disorder. In the United States alone, more than 50,000 patients are admitted with acute pancreatitis each year," wrote Dr. Olaf Bakker, of University Medical Center Utrecht in the Netherlands, and colleagues. "One of the most dreaded complications in these patients is infected necrotizing pancreatitis that leads to sepsis and is often followed by multiple organ failure."
Most patients with infected necrotizing pancreatitis require
necrosectomy. Surgical necrosectomy causes inflammation and has a
high complication rate, the researchers said in a journal news
Endoscopic transgastric necrosectomy is a new technique that is
performed with the patient under conscious sedation, instead of
general anesthesia. The procedure can reduce the risk of
inflammation and complications such as multiple organ failure,
according to the study authors.
The study appears in the March 14 issue of the
Journal of the American Medical Association.
The U.S. National Institute of Diabetes and Digestive and Kidney
Diseases has more about