Pancreatic necrosis: assessment of outcome related to quality of life and cost of management.

Ten patients with necrotizing pancreatitis admitted consecutively between August 1990 and August 1991 were studied. They comprised eight men and two women of median age 63 (range 29-73) years. One patient died. The median length of hospital stay was 74 (range 40-150) days. The median number of operations and endoscopic procedures performed per patient was 4 (range 2-7). Investigations performed included multiple bacteriological, radiological, haematological and biochemical tests. The mean cost of management was 18,441 pounds (range 9,296 pounds-33,796 pounds), of which hospitalization accounted for 65 per cent, operations and endoscopic procedures 20 per cent and investigations 16 per cent. Cost-utility analysis demonstrated a mean benefit per patient of 8.55 quality-adjusted life years gained at a cost of 2,157 pounds each. The management of pancreatic necrosis is expensive but justified by the excellent outcome in terms of quality of life.