Indications and outcome of surgical management of local complications of acute pancreatitis: a single-centre experience

Abstract

Background: Acute pancreatitis is a common and challenging disease that can develop both local and systemic complications. According to the Atlanta classification, local complications include peri-pancreatic collection, acute necrotic collection, pseudocyst and walled-off necrosis.Methods: A hospital-based retrospective study was conducted in the department of surgery at Kathmandu medical college teaching hospital. Patients were recruited using purposive sampling method and those who underwent laparoscopic, retroperitoneal or open surgical procedures for the management of local complications of acute pancreatitis from June 2017 to July 2021. The indication, perioperative outcome and associated complications were evaluated in all the cases.Results: Between June 2017 to July 2021, 432patients were admitted to the surgery department with acute pancreatitis or with complications of acute pancreatitis. Twenty-one patients required surgical intervention in the form of external drainage, cysto-enterostomy, VARD or open necrosectomy due to failure of endoscopic or radiological intervention or due to positions of lesions being inaccessible to these techniques. All patients had clinical improvement following surgery with an acceptable complication rate given the severity of the disease.Conclusions: Although various endoscopic techniques are now available to manage the pancreatic fluid collection and pancreatic necrosis, surgery remains essential in managing the disease.