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. 2024 Apr 5;73(5):787-796.
doi: 10.1136/gutjnl-2023-329735.

Long-term follow-up study of necrotising pancreatitis: interventions, complications and quality of life

Robbert A Hollemans  1   2 , Hester C Timmerhuis  3 , Marc G Besselink  4   5 , Stefan A W Bouwense  6 , Marco Bruno  7 , Peter van Duijvendijk  8 , Erwin-Jan van Geenen  9 , Muhammed Hadithi  10 , Sybrand Hofker  11 , Jeanin E Van-Hooft  12 , Liesbeth M Kager  13 , Eric R Manusama  14 , Jan-Werner Poley  15 , Rutger Quispel  16 , Tessa Römkens  17 , George P van der Schelling  18 , Matthijs P Schwartz  19 , Bernhard W M Spanier  20 , Martijn Stommel  21 , Adriaan Tan  22 , Niels G Venneman  23 , Frank Vleggaar  24 , Roy L J van Wanrooij  25 , Thomas L Bollen  26 , Rogier P Voermans  27 , Robert C Verdonk  28 , Hjalmar C van Santvoort  1   29 ; Dutch Pancreatitis Study Group
Affiliations

Long-term follow-up study of necrotising pancreatitis: interventions, complications and quality of life

Robbert A Hollemans et al. Gut. .

Abstract

Objective: To describe the long-term consequences of necrotising pancreatitis, including complications, the need for interventions and the quality of life.

Design: Long-term follow-up of a prospective multicentre cohort of 373 necrotising pancreatitis patients (2005-2008) was performed. Patients were prospectively evaluated and received questionnaires. Readmissions (ie, for recurrent or chronic pancreatitis), interventions, pancreatic insufficiency and quality of life were compared between initial treatment groups: conservative, endoscopic/percutaneous drainage alone and necrosectomy. Associations of patient and disease characteristics during index admission with outcomes during follow-up were assessed.

Results: During a median follow-up of 13.5 years (range 12-15.5 years), 97/373 patients (26%) were readmitted for recurrent pancreatitis. Endoscopic or percutaneous drainage was performed in 47/373 patients (13%), of whom 21/47 patients (45%) were initially treated conservatively. Pancreatic necrosectomy or pancreatic surgery was performed in 31/373 patients (8%), without differences between treatment groups. Endocrine insufficiency (126/373 patients; 34%) and exocrine insufficiency (90/373 patients; 38%), developed less often following conservative treatment (p<0.001 and p=0.016, respectively). Quality of life scores did not differ between groups. Pancreatic gland necrosis >50% during initial admission was associated with percutaneous/endoscopic drainage (OR 4.3 (95% CI 1.5 to 12.2)), pancreatic surgery (OR 3.2 (95% CI 1.1 to 9.5) and development of endocrine insufficiency (OR13.1 (95% CI 5.3 to 32.0) and exocrine insufficiency (OR6.1 (95% CI 2.4 to 15.5) during follow-up.

Conclusion: Acute necrotising pancreatitis carries a substantial disease burden during long-term follow-up in terms of recurrent disease, the necessity for interventions and development of pancreatic insufficiency, even when treated conservatively during the index admission. Extensive (>50%) pancreatic parenchymal necrosis seems to be an important predictor of interventions and complications during follow-up.

Keywords: ACUTE PANCREATITIS; INTERVENTIONAL RADIOLOGY; PANCREATIC SURGERY; PANCREATITIS; THERAPEUTIC ENDOSCOPY.

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Conflict of interest statement

Competing interests: None declared.

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