| Surgical treatment of severe acute pancreatitis: timing of operation is crucial for survival. | |
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MedLine Citation:
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PMID: 12906721 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: In patients operated on for severe acute pancreatitis (SAP) the impact of the timing of operation on outcome is controversial. MATERIALS AND METHODS: In a retrospective analysis of a prospectively documented database, we studied 250 patients suffering from SAP, who were in need for surgical treatment during their course of disease. RESULTS: From 1982 to 1998, 250 patients with the diagnosis of SAP who required operative treatment were admitted to the intensive care unit (ICU) of a university hospital. The mean APACHE II score on the day of admission was 16.1 (8-35). One hundred eighty-five patients (74%) required reoperation, of whom 111 patients (60%) underwent reoperation on demand and 74 (40%) patients a pre-planned reoperation. Overall mortality was 38.8% (97 patients). In patients who were operated during the first three weeks after onset of disease, mortality was significantly higher than in patients who were operated after three weeks (46% vs. 25%, p < 0.01). Besides patient age (p < 0.05), APACHE II score at admission (p < 0.01), multiple organ dysfunction (p < 0.01), infection of pancreatic necrosis (p < 0.05), surgical control of pancreatic necrosis (p < 0.0001), and the time of surgical intervention (p < 0.05) determined survival significantly. CONCLUSION: Patients who were operated later than three weeks after onset of disease had a significantly better outcome. In patients suffering from SAP who required surgical treatment, the timing of operation is crucial for survival. |
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Authors:
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Peter Götzinger; Peter Wamser; Ruth Exner; Erhard Schwanzer; Raimund Jakesz; Reinhold Függer; Thomas Sautner |
Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Surgical infections Volume: 4 ISSN: 1096-2964 ISO Abbreviation: Surg Infect (Larchmt) Publication Date: 2003 |
Date Detail:
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Created Date: 2003-08-08 Completed Date: 2003-10-14 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9815642 Medline TA: Surg Infect (Larchmt) Country: United States |
Other Details:
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Languages: eng Pagination: 205-11 Citation Subset: IM |
Affiliation:
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Department of Surgery, University of Vienna, Vienna, Austria. peter.goetzinger@akh-wien.ac.at |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Drainage Female Humans Male Middle Aged Pancreatectomy / methods* Pancreatitis, Acute Necrotizing / surgery* Retrospective Studies Survival Analysis Time Factors Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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