COMPARATIVE ANALYSIS OF EARLY NECROSECTOMY VS CONSERVATIVE MANAGEMENT ON PATIENT OUTCOMES OF ACUTE NECROTIZING PANCEREATITS

Abstract

Objective: The purpose of the research is to find out the comparative analysis of early necrosectomy vs conservative management on patient outcomes of acute necrotizing pancreatitis

Study Design: Comparative Cross-Sectional study

Study Duration: 06 months from February 2024-August 2024

Study Place: Department of General Surgery, CMH Abbottabad 

Methods: This was a cross-sectional comparative study, that compared the results of early necrosectomy and conservative management in patients who have acute necrotizing pancreatitis and are in a tertiary care facility (n=105). The patients were clustered according to their treatments and the results such as mortality, complications, stay, and ICU admission were compared using basic statistical tools. SPSS 26 was used for data analysis and p-value less than .05 was taken as significant.

Results: A total of105 patients were included and were divided into 2 groups. Group A comprised of 52 patients who underwent early necrosectomy, and Group B involved 53 patients with conservative management. Average age was 49.6 years and male population was 68.6%. gallstone was most common eitiology of pancreatitis. A higher rate of procedure related complications (bleeding and pancreatic fistula), increase in length of hospital and ICU stay, and an observed trend of increased mortality were linked to early necrosectomy. On the other hand, conservative management of patients who had a stable clinical presentation had a decreased number of adverse events and more positive overall results. Mean hospital stay and average ICU admission rate in group B was 15.2 and 22 respectively lesser than group A

Conclusion: The conservative treatment of acute necrotizing pancreatitis yields superior outcomes, such as reduced complications, and the necessity of invasive treatment as opposed to early necrosectomy. More dangerous conditions of early surgery include bleeding, fistulae, and infections, and should be used only in case of an infected necrosis or continuing organ failure in patients.