The burden of acute pancreatitis and early experience of step-up approach for acute necrotizing pancreatitis at Military Hospital
Introduction: Twenty-five percent of acute pancreatitis develops severe acute pancreatitis (SAP). SAP patients have prolonged hospitalization and require a substantial amount of manpower and hospital resources. The aim of this study was to give an insight into the burden of acute pancreatitis at a...
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Society of Surgeons of Nepal
2019
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oai:doaj.org-article:404ff4569ff7481f8a6dbf0f04b050172021-12-05T19:15:49ZThe burden of acute pancreatitis and early experience of step-up approach for acute necrotizing pancreatitis at Military Hospital10.3126/jssn.v22i2.287231815-39842392-4772https://doaj.org/article/404ff4569ff7481f8a6dbf0f04b050172019-12-01T00:00:00Zhttps://www.nepjol.info/index.php/JSSN/article/view/28723https://doaj.org/toc/1815-3984https://doaj.org/toc/2392-4772 Introduction: Twenty-five percent of acute pancreatitis develops severe acute pancreatitis (SAP). SAP patients have prolonged hospitalization and require a substantial amount of manpower and hospital resources. The aim of this study was to give an insight into the burden of acute pancreatitis at a tertiary level military hospital and to share the experience of managing pancreatic necrosis with the application of the step-up approach. Methods: A prospective descriptive study of consecutive patients was conducted at Shree Birendra Army Hospital from 2017 June to 2017 November. Patients with a diagnosis of acute pancreatitis admitted were stratified according to severity as per Revised Atlanta classification 2012. Patients with acute necrotizing pancreatitis were enrolled for the step-up approach. Patient’s demography, baseline investigations, radiology, prognostic scoring scales and type of intervention were analyzed. The burden of severe acute pancreatitis at our center and the early experience of the step-up approach at our centre within the study period were studied. Results: Out of 35 five patients with acute pancreatitis, 7 (20%) subsequently developed severe acute pancreatitis. Among them, five patients subsequently developed necrotizing pancreatitis who were managed according to the step-up approach. Out of them, three patients subsequently underwent operative intervention in the form of minimally invasive procedures like percutaneous drain placement, laparoscopic necrosectomy, video-assisted retroperitoneal debridement, and open necrosectomy. Conclusion: Acute pancreatitis is a common presentation at our centre. The step-up approach in the management of acute necrotizing pancreatitis is a safe and feasible approach. Sushil Bahadur RawalUttam LaudariBasanta KhatiwadaAnup ThapaManoj Kumar JhaJyoti RayamajhiSrijan MallaSociety of Surgeons of NepalarticleAcute pancreatitisPancreatic necrosisStep up approachSurgeryRD1-811ENJournal of Society of Surgeons of Nepal, Vol 22, Iss 2 (2019) |
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DOAJ |
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Acute pancreatitis Pancreatic necrosis Step up approach Surgery RD1-811 |
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Acute pancreatitis Pancreatic necrosis Step up approach Surgery RD1-811 Sushil Bahadur Rawal Uttam Laudari Basanta Khatiwada Anup Thapa Manoj Kumar Jha Jyoti Rayamajhi Srijan Malla The burden of acute pancreatitis and early experience of step-up approach for acute necrotizing pancreatitis at Military Hospital |
| description |
Introduction: Twenty-five percent of acute pancreatitis develops severe acute pancreatitis (SAP). SAP patients have prolonged hospitalization and require a substantial amount of manpower and hospital resources. The aim of this study was to give an insight into the burden of acute pancreatitis at a tertiary level military hospital and to share the experience of managing pancreatic necrosis with the application of the step-up approach.
Methods: A prospective descriptive study of consecutive patients was conducted at Shree Birendra Army Hospital from 2017 June to 2017 November. Patients with a diagnosis of acute pancreatitis admitted were stratified according to severity as per Revised Atlanta classification 2012. Patients with acute necrotizing pancreatitis were enrolled for the step-up approach. Patient’s demography, baseline investigations, radiology, prognostic scoring scales and type of intervention were analyzed. The burden of severe acute pancreatitis at our center and the early experience of the step-up approach at our centre within the study period were studied.
Results: Out of 35 five patients with acute pancreatitis, 7 (20%) subsequently developed severe acute pancreatitis. Among them, five patients subsequently developed necrotizing pancreatitis who were managed according to the step-up approach. Out of them, three patients subsequently underwent operative intervention in the form of minimally invasive procedures like percutaneous drain placement, laparoscopic necrosectomy, video-assisted retroperitoneal debridement, and open necrosectomy.
Conclusion: Acute pancreatitis is a common presentation at our centre. The step-up approach in the management of acute necrotizing pancreatitis is a safe and feasible approach.
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| format |
article |
| author |
Sushil Bahadur Rawal Uttam Laudari Basanta Khatiwada Anup Thapa Manoj Kumar Jha Jyoti Rayamajhi Srijan Malla |
| author_facet |
Sushil Bahadur Rawal Uttam Laudari Basanta Khatiwada Anup Thapa Manoj Kumar Jha Jyoti Rayamajhi Srijan Malla |
| author_sort |
Sushil Bahadur Rawal |
| title |
The burden of acute pancreatitis and early experience of step-up approach for acute necrotizing pancreatitis at Military Hospital |
| title_short |
The burden of acute pancreatitis and early experience of step-up approach for acute necrotizing pancreatitis at Military Hospital |
| title_full |
The burden of acute pancreatitis and early experience of step-up approach for acute necrotizing pancreatitis at Military Hospital |
| title_fullStr |
The burden of acute pancreatitis and early experience of step-up approach for acute necrotizing pancreatitis at Military Hospital |
| title_full_unstemmed |
The burden of acute pancreatitis and early experience of step-up approach for acute necrotizing pancreatitis at Military Hospital |
| title_sort |
burden of acute pancreatitis and early experience of step-up approach for acute necrotizing pancreatitis at military hospital |
| publisher |
Society of Surgeons of Nepal |
| publishDate |
2019 |
| url |
https://doaj.org/article/404ff4569ff7481f8a6dbf0f04b05017 |
| work_keys_str_mv |
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1718371057568579584 |