Influence of early surgery and endoscopic interventions on the risk of infection in patients with pancreatic necrosis

Lopushkov AV, Turovets MI, Ekstrem AV, et al. . Influence of early surgery and endoscopic interventions on the risk of infection in patients with pancreatic necrosis. Pirogov Russian Journal of Surgery. 2023;(11):56‑62. (In Russ.)
https://doi.org/10.17116/hirurgia202311156

Подписка 2025 (Pirogov Russian Journal of Surgery)

Использование инфографики авторами научных работ

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OBJECTIVE

To prevent purulent-septic complications in patients with destructive pancreatitis.

MATERIAL AND METHODS

A cohort study included 488 patients with pancreatic necrosis: group 1 (n=331) — active surgical strategy, group 2 (n=157) — follow-up and therapy. We used binary logistic regression to predict purulent-septic complications.

RESULTS

Original model of independent variables significantly (p<0.001) revealed 5.3 times higher risk of infectious complications after laparotomy within the first week after hospitalization. Incidence of these events increased by 2.8 times in patients biliary pancreatitis compared to alcohol-alimentary pancreatitis. Complication rate was higher in older patients (by 2.1% for each year). Risk of purulent-septic complications decreased by 57.4% in women compared to men. There was no significant correlation between risk of infectious complications and endoscopic procedures. Specificity and sensitivity of the model was 74.2 and 72.6%, respectively.

CONCLUSION

Original model significantly predicts the risk of purulent-septic complications within the first week after hospitalization. Refusal of early active surgical strategy in these patients will significantly reduce the likelihood of purulent-septic complications.

Keywords:

pancreatic necrosis

purulent-septic complications

surgical strategy for sterile pancreatic necrosis

laparoscopy

Authors:

Lopushkov A.V.

Volgograd State Medical University

ORCID: 0000-0001-7626-7383

Turovets M.I.

Volgograd State Medical University

ORCID: 0000-0003-0793-5098

Ekstrem A.V.

Volgograd State Medical University

ORCID: 0000-0002-0453-6158

Popov A.S.

Volgograd State Medical University

ORCID: 0000-0003-2241-8144

Burchuladze N.Sh.

Volgograd State Medical University

ORCID: 0000-0002-2327-857X

Kitaeva A.V.

Volgograd State Medical University

ORCID: 0000-0002-3707-173X

Vorobyova A.A.

Volgograd Medical University

ORCID: 0000-0003-0625-4063

Mikhin I.V.

Volgograd State Medical University

Scopus AuthorID: 6505984534
ResearcherID: C-1627-2016
ORCID: 0000-0002-0104-2822

Received:

17.04.2023

Accepted:

29.04.2023

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