Noah J Swann, MD, Nobel Letendre, BS, Brian Cox, MD, James Recabaren, MD, FACS. Huntington Hospital
Introduction: Debridement of pancreatic necrosis is traditionally considered a morbid procedure. Previous multi-center studies using 2007 data have demonstrated 6.8% 30-day mortality for pancreatic necrosectomy; Laparoscopic and percutaneous management of pancreatic and peri-pancreatic necrosis have become increasingly prevalent, but haven’t fully supplanted the traditional open pancreatic Necrosectomy.
Objective: To evaluate the outcomes of pancreatic necrosectomy. Patient demographics, Ranson criteria, patient morbidity and mortality (both observed and expected) were analyzed. A multivariate stepwise regression was performed to analyze the clinical and laboratory parameters predictive of mortality. Patient demographics and comorbidities were analyzed. Post-operative complications were also evaluated.
Participants: The NSQIP national database was searched for all patients who had pancreatic or peri-pancreatic debridement using the Current Procedural Technology (CPT) code 48015 from January 1st, 2007 to December 31st 2015. After exclusion,1590 patients were identified during a 9 year interval.
Results: The patient population was predominantly male (71.2%) and Caucasian (69.8%). The mean age was 53.2 years; mean BMI was 29.7. Smokers comprised 24.1% of the cohort, with 33.9% of the cohort manifesting diabetes. The in hospital mortality (30 day) was 6.8%. Patient BMI (OR 1.02-1.07), Age (1.01-1.03), BUN (1.02–1.03), INR (1.48–4.46), albumin (0.36–0.54) and total bilirubin (1.16-1.31) were independent predictors of mortality. All of these factors reached statistical significance with p-values < 0.05 and significant odds ratios.
Conclusions: Our data demonstrates that pancreatic and peri-pancreatic debridement continues to be a morbid procedure, with 30 day in-hospital mortality (6.8%) and overall morbidity similar to previous multi-center studies. We reaffirmed that BUN and Age were independent risk factors for mortality. BMI, INR, total bilirubin and albumin have also been demonstrated to be independent markers for mortality.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94652
Program Number: P260
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster