AI Article Synopsis
- This study investigates whether early or late intervention is more effective for treating necrotizing pancreatitis, focusing on mortality and complications.
- A systematic review analyzed 14 studies comparing outcomes of early (<4 weeks) versus late intervention (≥4 weeks) and found significant differences.
- Results indicate that late interventions, whether open necrosectomy or minimally invasive, are associated with lower mortality rates and fewer complications in patients with necrotizing pancreatitis.
Article Abstract
Objectives: Postponed open necrosectomy or minimally invasive intervention has become the treatment option for necrotizing pancreatitis. Nevertheless, several studies point to the safety and efficacy of early intervention for necrotizing pancreatitis. Therefore, we conducted a systematic review and meta-analysis to compare clinical outcomes of acute necrotizing pancreatitis between early and late intervention.
Methods: Literature search was performed in multiple databases for articles that compared the safety and clinical outcomes of early (<4 weeks from the onset of pancreatitis) versus late intervention (≥4 weeks from the onset of pancreatitis) for necrotizing pancreatitis published up to August 31, 2022. The meta-analysis was performed to determine pooled odds ratio (OR) of mortality rate and procedure-related complications.
Results: Fourteen studies were included in the final analysis. For open necrosectomy intervention, the overall pooled OR of mortality rate with the late intervention compared with early intervention was 7.09 (95% confidence interval [CI] 2.33-21.60; I = 54%; P = 0.0006). For minimally invasive intervention, the overall pooled OR of mortality rate with the late intervention compared with early intervention was 1.56 (95% CI 1.11-2.20; I = 0%; P = 0.01). The overall pooled OR of pancreatic fistula with the late minimally invasive intervention compared with early intervention was 2.49 (95% CI 1.75-3.52; I = 0%; P < 0.00001).
Conclusion: These results showed the benefit of late interventions in patients with necrotizing pancreatitis in both minimally invasive procedures and open necrosectomy. Late intervention is preferred in the management of necrotizing pancreatitis.
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| http://dx.doi.org/10.1111/1751-2980.13201 | DOI Listing |
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