07 July 2022: Clinical Research
Optimal Timing and Outcomes of Minimally Invasive Approach in Acute Biliary Pancreatitis
Mihai Faur 12ABCE , Sorin Radu Fleaca 1CDFG , Claudia Diana Gherman 3ACF , Denisa Tanasescu 4BCEF , Ciprian Ionut Bacila 1CDFG , Dragos Serban 56CDF** , Laura Carina Tribus 78CDF , Corneliu Tudor 6DEF , Gabriel Catalin Smarandache 56CDF* , Daniel Ovidiu Costea 910CEF* , Mihail Silviu Tudosie 1112CEF , Dan Sabau 12ABCF , Gabriel Andrei Gangura 513DEF* , Ciprian Tanasescu 12ABCFDOI: 10.12659/MSM.937016
Med Sci Monit 2022; 28:e937016
Table 2 Types of surgeries and outcomes in the study groups.
| Parameter | Mild ABP (n=53) | Medium-severe ABP (n=24) | Severe ABP (n=57) | Total (n=143) | P value |
|---|---|---|---|---|---|
| Type of surgery: | ** | ||||
| • ERCP+LC at 24–48 h | 41 (77.4%) | 0 | 0 | 41 (30.6%) | |
| • LC | 12 (22.6%) | 24 (100.0%) | 0 | 36 (26.9%) | |
| • Laparoscopic biliary drainage (cholecystostomy) +LC at 5–7 days | 0 | 0 | 57 (100.0%) | 57 (42.5%) | |
| Systemic complications (no.; %) | 3 (5.7%) | 4 (16.7%) | 17 (29.8%) | 24 (12.5%) | 0.002** |
| Distribution of systemic complications: | 0.089 | ||||
| • Digestive superior hemorrhage (mild) | 1 (1.9%) | 1 (4.2%) | 2 (3.5%) | 4 (2.7%) | |
| • Malign arterial hypertension | 0 | 1 (4.2%) | 0 | 2 (1.4%) | |
| • Acute coronary event | 1 (1.9%) | 0 | 1 (1.8%) | 2 (1.4%) | |
| • MSOF | 0 | 0 | 1 (1.8%) | 1 (0.7%) | |
| • Pleurisy/pulmonary infiltrates | 0 | 1 (4.2%) | 10 (17.5%) | 11 (7.6%) | |
| • Pulmonary embolism | 1 (1.9%) | 0 | 1 (1.8%) | 2 (1.4%) | |
| • Respiratory failure | 0 | 1 (4.2%) | 0 | 1 (0.7%) | |
| • Sepsis | 0 | 0 | 1 (1.8%) | 1 (0.7%) | |
| Local complications (no.;%) | 3 (5.7%) | 4 (16.6%) | 11 (19.3%) | 18 (15.7%) | 0.021** |
| Distribution of local complications: | 0.103** | ||||
| • Intrabdominal abscess | 0 | 1 (4.2%) | 1 (1.8%) | 2 (1.4%) | |
| • Pancreatic abscess | 0 | 0 | 3 (5.2%) | 3 (2.1%) | |
| • Bile leak | 1 (1.9%) | 1 (4.2%) | 2 (3.5%) | 5 (3.4%) | |
| • Hemorrhage | 1 (1.9%) | 1 (4.2%) | 3 (5.2%) | 5 (3.4%) | |
| • Pancreatic pseudocyst | 0 | 1 (4.2%) | 2 (3.5%) | 3 (2.1%) | |
| • Seroma | 1 (1.9%) | 0 | 0 | 1 (0.7%) | |
| HAIs (no., %): | 1 (1.9%) | 2 (8.3%) | 9 (15.7%) | 13 (9.7%) | 0.095** |
| • Clostridium | 0 | 0 | 5 (8.8%) | 5 (3.7%) | |
| • Urinary infections | 0 | 1 (4.2%) | 2 (3.5%) | 3 (2.2%) | |
| • Pneumonia | 0 | 0 | 1 (1.8%) | 1 (0.7%) | |
| • SSI | 1 (1.9%) | 1 (4.2%) | 1 (1.8%) | 3 (2.2%) | |
| • Thrombophlebitis | 0 | 0 | 1 (1.7%) | 1 (0.7% | |
| Deaths (no., %): | 0 | 1 (4.2%) | 3 (5.3%) | 4 (3%) | 0.235 |
| Causes of deaths: | |||||
| • MSOF | 0 | 0 | 1 (1.8%) | 1 (0.7%) | NS |
| • Respiratory failure | 0 | 1 (4.1%) | 0 | 1 (0.7%) | NS |
| • Pulmonary embolism | 0 | 0 | 1 (1.8%) | 1 (0.7%) | NS |
| • Sepsis, pleurisy | 0 | 0 | 1 (1.8%) | 1 (0.7%) | NS |
| Mean hospital stay±SD (days) | 5.1±4.1 | 7.4±1.8 | 10±2.4 | 7.6±3.8 | ** |
| * Kruskal-Wallis test; ** Fisher exact test. ERCP – endoscopic retrograde cholangiopancreatography; HAI – hospital-acquired infection; LC – laparoscopic cholecystectomy; MSOF – multisystem organ failure; SSI – surgical site infection. | |||||