Table of Contents    
Original Article
 
Surgical treatment of severe acute pancreatitis: After 15 years of practice
Jorge Pereira1, Júlio Constantino1, Liliana Duarte2, Helena Pinho3, Luis Pinheiro4
1Surgical Specialist, Centro Hospitalar Tondela-Viseu, Viseu, Portugal.
2Surgical Resident, Centro Hospitalar Tondela-Viseu, Viseu, Portugal.
3Surgical Consultant, Centro Hospitalar Tondela-Viseu, Viseu, Portugal.
4Surgical Chief, Centro Hospitalar Tondela-Viseu, Viseu, Portugal.

Article ID: 100038IJHPDJP2015
doi:10.5348/ijhpd-2015-38-OA-13

Address correspondence to:
Jorge de Almeida Pereira
Serviço de Cirurgia 1
Centro Hospitalar Tondela-Viseu, Avenida Rei D.Duarte
3504-509 Viseu
Portugal
Phone: +351 96 636 4759

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How to cite this article
Pereira J, Constantino J, Duarte L, Pinho H, Pinheiro L. Surgical treatment of severe acute pancreatitis: After 15 years of practice. Int J Hepatobiliary Pancreat Dis 2015;5:74–81.


Abstract
Aims: We evaluated the surgical treatment of severe acute pancreatitis by analyzing the surgical methods and clinical outcomes during a 15-year period in our Department of Surgery with the goal of improving our performance. The aim of the study was to investigate the correlation between clinical factors and mortality in these patients.
Methods: The study included the medical records of patients diagnosed with severe acute pancreatitis (Atlanta 2012 classification) who were surgically treated between 2000 and 2014 (15 years) in the Department of Cirurgia 1, Centro Hospitalar Tondela-Viseu in Portugal. The data were statistically analyzed using SPSS® Version 22 IBM® software.
Results: A total of 39 patients were included, mostly men with an average age of 58.7 years. The most prevalent etiology was gallstones (41% of cases). The following variables showed an independent relationship with mortality: age, length of stay, Ranson score, APACHE II (acute physiology and chronic health evaluation II) scores at admission and surgery, hematocrit, and renal, respiratory and cardiovascular failures.
Conclusion: Findings are similar to those found in previous reports. The Ranson score and APACHE II scores are good prognostic factors for severe acute pancreatitis. Moreover, in this series, APACHE II at surgery appears to be the best predictor of mortality; a cut-off of 21 allowed for an 86.7% sensitivity and a 91% specificity.

Keywords: Acute pancreatitis, Multiple organ failure, Necrotizing pancreatitis, Surgery

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Author Contributions:
Jorge Pereira – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Júlio Constantino – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Liliana Duarte – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Helena Pinho – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Luis Pinheiro – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2015 Jorge Pereira et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.