07 July 2022 : Clinical Research
Optimal Timing and Outcomes of Minimally Invasive Approach in Acute Biliary Pancreatitis
Mihai Faur12ABCE, Sorin Radu Fleaca
1CDFG, Claudia Diana Gherman3ACF, Ciprian Ionut Bacila1CDFG, Denisa Tanasescu4BCEF, Dragos Serban 56CDF*, Laura Carina Tribus78CDF, Corneliu Tudor 6DEF, Gabriel Catalin Smarandache96CDF, Daniel Ovidiu Costea1011CEF, Mihail Silviu Tudosie1213CEF, Dan Sabau12ABCF, Gabriel Andrei Gangura914DEF, Ciprian Tanasescu12ABCF
DOI: 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: | <0.001** | ||||
| • 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 | <0.001** |
| * 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. | |||||