TY - JOUR
T1 - Long-term follow-up study of necrotising pancreatitis
T2 - Interventions, complications and quality of life
AU - Hollemans, Robbert A.
AU - Timmerhuis, Hester C.
AU - Besselink, Marc G.
AU - Bouwense, Stefan A. W.
AU - Bruno, Marco
AU - van Duijvendijk, Peter
AU - van Geenen, Erwin-Jan
AU - Hadithi, Muhammed
AU - Hofker, Sybrand
AU - van-Hooft, Jeanin E.
AU - Kager, Liesbeth M.
AU - Manusama, Eric R.
AU - Poley, Jan-Werner
AU - Quispel, Rutger
AU - Römkens, Tessa
AU - van der Schelling, George P.
AU - Schwartz, Matthijs P.
AU - Spanier, Bernhard W. M.
AU - Stommel, Martijn
AU - Tan, Adriaan
AU - Venneman, Niels G.
AU - Vleggaar, Frank
AU - van Wanrooij, Roy L. J.
AU - Bollen, Thomas L.
AU - Voermans, Rogier P.
AU - Verdonk, Robert C.
AU - van Santvoort, Hjalmar C.
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2024/1/24
Y1 - 2024/1/24
N2 - Objective: To describe the long-term consequences of necrotising pancreatitis, including complications, the need for interventions and the quality of life. Design: Long-term follow-up of a prospective multicentre cohort of 373 necrotising pancreatitis patients (2005-2008) was performed. Patients were prospectively evaluated and received questionnaires. Readmissions (ie, for recurrent or chronic pancreatitis), interventions, pancreatic insufficiency and quality of life were compared between initial treatment groups: conservative, endoscopic/percutaneous drainage alone and necrosectomy. Associations of patient and disease characteristics during index admission with outcomes during follow-up were assessed. Results: During a median follow-up of 13.5 years (range 12-15.5 years), 97/373 patients (26%) were readmitted for recurrent pancreatitis. Endoscopic or percutaneous drainage was performed in 47/373 patients (13%), of whom 21/47 patients (45%) were initially treated conservatively. Pancreatic necrosectomy or pancreatic surgery was performed in 31/373 patients (8%), without differences between treatment groups. Endocrine insufficiency (126/373 patients; 34%) and exocrine insufficiency (90/373 patients; 38%), developed less often following conservative treatment (p<0.001 and p=0.016, respectively). Quality of life scores did not differ between groups. Pancreatic gland necrosis >50% during initial admission was associated with percutaneous/endoscopic drainage (OR 4.3 (95% CI 1.5 to 12.2)), pancreatic surgery (OR 3.2 (95% CI 1.1 to 9.5) and development of endocrine insufficiency (OR13.1 (95% CI 5.3 to 32.0) and exocrine insufficiency (OR6.1 (95% CI 2.4 to 15.5) during follow-up. Conclusion: Acute necrotising pancreatitis carries a substantial disease burden during long-term follow-up in terms of recurrent disease, the necessity for interventions and development of pancreatic insufficiency, even when treated conservatively during the index admission. Extensive (>50%) pancreatic parenchymal necrosis seems to be an important predictor of interventions and complications during follow-up.
AB - Objective: To describe the long-term consequences of necrotising pancreatitis, including complications, the need for interventions and the quality of life. Design: Long-term follow-up of a prospective multicentre cohort of 373 necrotising pancreatitis patients (2005-2008) was performed. Patients were prospectively evaluated and received questionnaires. Readmissions (ie, for recurrent or chronic pancreatitis), interventions, pancreatic insufficiency and quality of life were compared between initial treatment groups: conservative, endoscopic/percutaneous drainage alone and necrosectomy. Associations of patient and disease characteristics during index admission with outcomes during follow-up were assessed. Results: During a median follow-up of 13.5 years (range 12-15.5 years), 97/373 patients (26%) were readmitted for recurrent pancreatitis. Endoscopic or percutaneous drainage was performed in 47/373 patients (13%), of whom 21/47 patients (45%) were initially treated conservatively. Pancreatic necrosectomy or pancreatic surgery was performed in 31/373 patients (8%), without differences between treatment groups. Endocrine insufficiency (126/373 patients; 34%) and exocrine insufficiency (90/373 patients; 38%), developed less often following conservative treatment (p<0.001 and p=0.016, respectively). Quality of life scores did not differ between groups. Pancreatic gland necrosis >50% during initial admission was associated with percutaneous/endoscopic drainage (OR 4.3 (95% CI 1.5 to 12.2)), pancreatic surgery (OR 3.2 (95% CI 1.1 to 9.5) and development of endocrine insufficiency (OR13.1 (95% CI 5.3 to 32.0) and exocrine insufficiency (OR6.1 (95% CI 2.4 to 15.5) during follow-up. Conclusion: Acute necrotising pancreatitis carries a substantial disease burden during long-term follow-up in terms of recurrent disease, the necessity for interventions and development of pancreatic insufficiency, even when treated conservatively during the index admission. Extensive (>50%) pancreatic parenchymal necrosis seems to be an important predictor of interventions and complications during follow-up.
KW - ACUTE PANCREATITIS
KW - INTERVENTIONAL RADIOLOGY
KW - PANCREATIC SURGERY
KW - PANCREATITIS
KW - THERAPEUTIC ENDOSCOPY
UR - https://www.scopus.com/pages/publications/85183875880
U2 - 10.1136/gutjnl-2023-329735
DO - 10.1136/gutjnl-2023-329735
M3 - Article
C2 - 38267201
SN - 0017-5749
VL - 73
SP - 787
EP - 796
JO - Gut
JF - Gut
IS - 5
M1 - gutjnl-2023-329735
ER -