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To study the outcome of Delayed surgical debridement in patients of necrotising pancreatitis.

Amey Doke, Nidhi Kandoi, Jayant Gadekar, Karan Parve Patil.

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Background: Acute Pancreatitis is one of the most commonly encountered diseases amongst alcoholic patients in western Maharashtra. One of its commonest sequelae is necrotising pancreatitis.
Methods: A retrospective study with a total of 27 patients were included in the study (with a prevalence of 1.3, Confidence level at 95%, error 5%and Attrition of 10%). Patients refractory to conservative were considered for Open Surgical Debridement. Data about the surgical and post-surgical outcomes were evaluated and studied.
Results: It was seen that the majority of patients with necrotizing pancreatitis (37%) were in the age group of 21-30yrs of age, followed by 31-40yrs (25.9%). The majority of the patients were male (85.2%) with a male: female ratio of 5.75:1. The aetiology of necrotizing pancreatitis showed 77.8% were alcoholics, and 14.8% had gall stone and traumatic in 7.4% patients. In 29.6% of cases, surgery was performed ≤21 days; in 70.4% of cases, surgery was performed after 21 days. While studying the outcome, it was seen that 85.2% of patients survived, while death was reported in 14.8% of patients.
Conclusion: Surgical debridement with the closure of drains is a viable option in stable patients, and a policy to perform delayed necrosectomy may be prudent.

Key words: Acute pancreatitis, Acute necrotic collection (ANC), Walled-off pancreatic necrosis (WOPN), APACHE II SCORE, CTSI SCORE

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