Introduction Dearth in the literature pertaining to natural history of acute pancreatitis (AP) necessitates further studies to evaluate the outcome of local pancreatic complications using the revised Atlanta classification.
Objective To evaluate the outcomes of local pancreatic complications after first episode of AP, risk factors for their development and predictors of need for intervention.
Methodology A prospective study was carried out on 50 consecutive cases of AP who developed local pancreatic complications from January 2015 to July 2016. After imaging, they were categorised into acute pancreatic fluid collection (APFC) and acute necrotic collection (ANC). The risk factors for their development and the need for intervention were assessed.
Results Of 50 patients, 20 developed APFC and 30 ANC. Of ANC cases, 27 progressed into walled-off necrosis (WON), of which 4 were managed conservatively and 18 collections were drained percutaneously, 3 underwent endotherapy (transmural drainage and endoscopic necrosectomy) and 2 died following percutaneous drainage (PCD) and surgery. Ten WON collections persisted at the end of 3rd month. Collections resolved in 6 of 20 APFC patients, 14 formed pseudocysts, of which 10 showed resolution with or without intervention and only 4 of them persisted at the end of study. Size of collection ≥6 cm was independent predictor of intervention irrespective of type of collections while in cases of ANC, extensive necrosis (>30%) and multiple collections were more likely to require intervention.
Conclusion Incidence of ANC is more common than APFC when local pancreatic fluid collections develop most of which develop WON and require intervention.
- Pancreatic disease
- Internal medicine
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Contributors AK: Clinical patient handling, literature search, data acquisition and analysis, manuscript preparation. MG: Concept, design, intellectual content, literature search, clinical studies, data acquisition, manuscript preparation, editing and review. SK: Radiological work up and intervention, intellectual content, manuscript editing and review (deceased April 2019). RS, SSL : Intellectual content, literature search, data acquisition, manuscript editing and review.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.
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