DE WAELE JJ, BLOT S, HOSTE E, VANDEWOUDE K, COLARDYN F; Interscience Conference on Antimicrobial Agents and Chemotherapy (42nd : 2002 : San Diego, Calif.).
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2002 Sep 27-30; 42: abstract no. K-1805.
Ghent University Hospital, Ghent, Belgium.
BACKGROUND: Intra abdominal infections frequently complicate the postoperative course of patients with acute necrotizing pancreatitis. The objective of this study was to analyze the incidence of pancreatic surinfection after surgery for acute necrotizing pancreatitis, describe its characteristics and identify associated risk factors. METHODS: We retrospectively (1995-2001) analyzed 46 patients treated surgically for acute pancreatitis. Surgical treatment consisted of debridement and postoperative continuous lavage. We recorded demographic characteristics, incidence of organ failure, data on surgical and infectious complications, data on surgical and medical treatment and disease severity by Ranson and APACHE II score. RESULTS: Surinfection of the pancreatic necrosis was present in 30 out of 46 patients (65%). The surinfection was polymicrobial in 17 patients. Most of the organisms were gram- negative (54%), the others were gram-positives (28%) or fungi (17%). Patients with surinfected necrosis were younger (50 y vs. 64, p<0,01), had surgical complications more often (70% vs. 26,7%, p=0,01), needed retroperitoneal lavage for a longer time (28 days vs. 9, p<0,01), and had a longer hospital stay (84 days vs. 29, p<0,001) than patients without surinfection. Multivariate analysis demonstrated that age (OR 0,90; 95% CI: 0,83-0,97, p<0,01) and the occurrence of a surgical complication OR 10; 95% CI 1,53-66,6, p<0,01) were independently associated with pancreatic surinfection. The mortality in patients with infected necrosis was higher (72% vs. 40%, p=0.04), although in multivariate analysis no association was found. CONCLUSIONS: Pancreatic surinfection is high after debridement and retroperitoneal lavage, with mainly gram negative bacteria involved. Surgical complications and younger age are significant risk factors for surinfection.
Publication Types:
Keywords:
- Acute Disease
- Cholangiopancreatography, Endoscopic Retrograde
- Debridement
- Disease Progression
- Humans
- Incidence
- Irrigation
- Necrosis
- Pancreas
- Pancreatitis
- Pancreatitis, Acute Necrotizing
- Postoperative Care
- Risk Factors
- Treatment Outcome
- radiography
- surgery
Other ID:
UI: 102268263
From Meeting Abstracts