Morphological and functional outcome after pancreatic necrosectomy and lesser sac lavage for necrotizing pancreatitis.
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2007-09-30
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Abstract
BACKGROUND: Immediate outcomes after pancreatic necrosectomy have improved in recent years. This study reviews our short-term to medium-term experience of structural and functional changes in the pancreas after necrosectomy.
METHODS: Ten patients (8 males, median age 35 years), discharged after pancreatic necrosectomy for acute necrotizing pancreatitis between 1996 and 1998 were reviewed after a median period of 22 months. Clinical evidence of pancreatic dysfunction was documented at follow-up interview. Patients underwent computed tomography of the abdomen, endoscopic retrograde pancreatography, oral glucose tolerance test, fecal fat estimation and fasting serum C-peptide estimation (CPE).
RESULTS: No patient had repeat episodes of pancreatitis during the follow-up period. Three patients developed de-novo diabetes after discharge. No patient had symptoms of steatorrhea. Five patients showed severe changes on CECT. ERCP showed marked changes in six patients, the commonest being an abrupt cut-off of the main pancreatic duct. Glucose tolerance was abnormal in three patients and impaired in two patients while fecal fat excretion was abnormal in 8 patients.
CONCLUSIONS: Severe acute pancreatitis and necrosectomy are associated with significant structural and functional changes on medium-term follow-up.
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Reddy MS, Singh S, Singh R, Singh K, Singh G. Morphological and functional outcome after pancreatic necrosectomy and lesser sac lavage for necrotizing pancreatitis. Indian Journal of Gastroenterology. 2007 Sep-Oct; 26(5): 217-20