Long-term follow-up of patients with necrotizing pancreatitis treated by percutaneous necrosectomy.

BACKGROUND/AIMS: The objective of this follow-up study was to assess the long-term outcome of patients with infected necrotizing pancreatitis treated with percutaneous catheter drainage and necrosectomy.

METHODOLOGY

Nine patients (median age 44 years, range 19-69) with infected pancreatic necrosis and catheter drainage for initial treatment were evaluated after a median follow-up of 30 months (range 15-52) with respect to quality of life (pain, diarrhea, fat intolerance), morphology and endocrine and exocrine pancreatic function.

RESULTS

At follow-up all 9 patients (100%) were in good general condition with respect to quality of life. Only 2/9 (22%) patients had moderate to marked changes in computed tomography. There was mild to moderate exocrine dysfunction in 5/8 (63%) patients, 2/8 (25%) patients had a severe restriction of the exocrine pancreatic function; in one patient the serum pancreoaryl test was normal. An oral glucose tolerance test was performed in 6/9 patients, with a normal result in 3/6 (50%) patients. 2/6 (33%) patients had an impaired oral glucose tolerance test with metabolic pathogenesis. One patient with diabetes in the oral glucose tolerance test had a preexisting type II diabetes requiring insulin therapy since the onset of acute pancreatitis. In 3/9 (33%) patients an oral glucose tolerance test was not performed due to known preexisting diabetes.

CONCLUSIONS

Percutaneous drainage of infected necrotizing pancreatitis has given good long-term results with regard to quality of life, endocrine and exocrine pancreatic function and may be an alternative to surgical treatment.