FTP7.9 Not all necrotising pancreatitis are the same: does aetiology affect the extent pancreatic necrosis? A single-centre retrospective study

Abstract

Abstract Aim To assess the extent of pancreatic necrosis (PN) on abdominal computed tomography (CT) in patients with acute gallstone pancreatitis (GP) and alcohol-induced pancreatitis (AIP). Methods Patients ≥ 18-year-old with first-time onset of GP, AIP and PN on CT scan, from January 2010 to September 2018, were included. Extent of PN on CT, organ failure rate, admission to the intensive care unit (ICU), were compared between GP (group 1) and AIP (group 2). PN extent was described as: localised – right or left of the midline; diffuse – across the midline; more/less than 50% of the pancreas. Analysis of continuous and categorical data and multiple logistic regression were conducted. Significance was set at p<0.05. Results One hundred-two consecutive patients, 66 in group 1, 36 in group 2, were included. Overall, diffuse PN occurred in 34.3% of cases, more frequently in group 1 (42.4% vs 19.4%, p=0.03). Single/multiorgan failure developed in 50 patients, 57.6% belonged to group 1 (p=0.03). Predictors of organ failure were diffuse pattern of PN (OR 2.70, 95% CI 1.03 to 7.03, p=0.004) and PN ≥50% (OR 5.50, 95% CI 1.39 to 21.6, p=0.01). Admission to ICU was required in 27 subjects; PN ≥50% predicted ICU admission (OR 8.93, 95% CI 2.68 to 29.73, p=0.0004). The median hospital stay was 12 days (range 1-265), longer in group 1 (12.5 vs 10.5, p=0.02). Conclusions Diffuse PN occurred more frequently in patients with GP. A larger extent of PN predicted the onset of single/multiorgan failure and admission to the ICU.