CLINICAL, DIAGNOSTIC AND THERAPEUTIC CHARACTERIZATION OF PATIENTS WITH PANCREATIC COLLECTIONS DUE TO ACUTE PANCREATITIS IN A REFERRAL HOSPITAL
- PMID: 40699042
- PMCID: PMC12289286
- DOI: 10.1590/S0004-2803.24612024-105
CLINICAL, DIAGNOSTIC AND THERAPEUTIC CHARACTERIZATION OF PATIENTS WITH PANCREATIC COLLECTIONS DUE TO ACUTE PANCREATITIS IN A REFERRAL HOSPITAL
Abstract
Background: Pancreatic collections are a common complication of acute pancreatitis. In Latin America, information on the types of pancreatic collections and their management is limited and may vary between regions depending on the availability of highly specialised and minimally invasive treatment resources.
Methods: Retrospective cohort of patients with acute pancreatic collections secondary to acute pancreatitis treated at the Hospital Universitario San Ignacio, Bogotá (Colombia) between 2012-2023. Clinical characteristics, laboratory profiles and treatment received were described, comparing those who had a fatal outcome with those who did not.
Results: Of 689 patients with acute pancreatitis, 113 presented with pancreatic collection (55.1% women, mean age 55 years). Of these, 47.8% presented with acute necrotic collection, 36.3% with acute fluid collection, 9.7% with walled-off necrosis and 6.2% with pancreatic pseudocyst. C-reactive protein, BUN, creatinine levels (at admission and at 48 hours), PaO2/FiO2 (at admission and at 48 hours) and antibiotic use were significantly associated with mortality (P<0.05). The majority of acute necrotic collections, walled-off necrosis and pseudocysts received interventional management, with minimally invasive and combined management being more common than surgical management. Antibiotic management was used in 48.6% of collections, although microbiological isolation was performed in only 24.7% of cases.
Conclusion: Acute collections are a common and heterogeneous complication of pancreatitis, requiring intervention more often in complicated collections. Certain laboratory parameters seem to be more associated with mortality.
Background: • Pancreatic collections are a common complication of acute pancreatitis.
Background: • Their management depends on the availability of specialized and minimally invasive resources.
Background: • A study conducted on 689 patients with acute pancreatitis showed that 113 developed pancreatic collections.
Background: • Acute pancreatic collections are frequent and heterogeneous complications of pancreatitis.
Background: • Some altered laboratory parameters (creatinine, urea, C-reactive protein, and FiO2) seem to be more associated with mortality.
Contexto:: Coleções pancreáticas são uma complicação comum da pancreatite aguda. Na América Latina, as informações sobre os tipos de coleções pancreáticas e seu manejo são limitadas e podem variar entre regiões, dependendo da disponibilidade de recursos especializados e minimamente invasivos.
Métodos:: Estudo de coorte retrospectivo com pacientes apresentando coleções pancreáticas secundárias à pancreatite aguda, atendidos no Hospital Universitário San Ignacio, Bogotá (Colômbia), entre 2012 e 2023. Foram descritas características clínicas, perfis laboratoriais e tratamentos recebidos, comparando pacientes com e sem desfecho fatal.
Resultados:: Dos 689 pacientes com pancreatite aguda, 113 desenvolveram coleções pancreáticas (55,1% mulheres, idade média de 55 anos). Entre eles, 47,8% apresentaram coleção necrótica aguda, 36,3% coleção líquida aguda, 9,7% necrose encapsulada e 6,2% pseudocisto pancreático. Níveis de proteína C reativa, ureia, creatinina (na admissão e após 48 horas), PaO2/FiO2 (na admissão e após 48 horas) e uso de antibióticos foram significativamente associados à mortalidade (P<0,05). A maioria das coleções necróticas agudas, necrose encapsulada e pseudocistos recebeu tratamento intervencionista, sendo os métodos minimamente invasivos e combinados mais comuns do que a abordagem cirúrgica. O uso de antibióticos ocorreu em 48,6% dos casos, embora o isolamento microbiológico tenha sido realizado em apenas 24,7% dos pacientes.
Conclusão:: As coleções pancreáticas agudas são complicações frequentes e heterogêneas da pancreatite, exigindo intervenção principalmente em casos mais complexos. Alguns parâmetros laboratoriais parecem estar mais associados à mortalidade.
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