Surgical decompression for the management of abdominal compartment syndrome with severe acute pancreatitis: A narrative review

Table 1 Demographic data of observational studies on abdominal compartment syndrome with acute pancreatitis

Ref.	Country of origin	Type of study	Number of patients with ACS/total studied patients	Etiology of acute pancreatitis, n (%)	Age (yr), mean ± SD, median (IQR)	Female, n (%)
Husu et al[22], 2021	Finland	Retrospective matched-case control	OA: 40/47 (85.1%). CG: 21/47 (44.7%)	Alcohol: 85% (OA), 72% (CG). Biliary: 4.3% (OA), 14.9% (CG). HTG: 4.3% (OA), 2.1% (CG)	OA: 49 (27-82). CG: 50 (18-78)	OA: 10.6%. CG: 12.8%
Smit et al[12], 2016	Netherlands	Retrospective	13/29 (44.8%)	Biliary: 40.7%. Alcohol: 22%	55 ± 15	3 (23%)
Peng et al[11], 2016	China	Retrospective	273/273 (100%)	Biliary: 41%. Alcohol: 30%. Post ERCP: 10%	46 (17-78)	26 (42.6%)
Davis et al[14], 2013	Canada	Retrospective	16/45 (35.6%)	Biliary: 53%. Alcohol: 26.7%	59 ± 13	9 (20%)
Boone et al[15], 2013	United States	Retrospective	12/12 (100%)	Biliary: 41.7%. Alcohol: 33.3%	56 ± 13	1 (8.3%)
Leppäniemi et al[16], 2011	Finland	Retrospective	10/10 (100%)	Alcohol: 9 (90%). Drug: 1 (10%)	46 (33-61)	1 (10%)
Deng et al[17], 2011	China	Retrospective	8/8 (100%)	Alcohol: 8/8	51.5 (35-66)	2 (25%)
Mentula et al[18], 2010	Finland	Retrospective	26/26 (100%)	Alcohol: 81%. Drug: 8%. Post ERCP: 4%	42 (35-49)	3 (11.5%)
Chen et al[19], 2008	China	Retrospective	20/44 (45.5%)	Biliary: 59.1%. Alcohol: 11.4%. HTG: 15.9%	62.6 ± 11.1	21 (47.7%)
De Waele et al[20], 2005	Belgium	Prospective	21/44 (47.7%)	Biliary: 33%. Alcohol: 38%. HTG: 14%	53 (45-68)	16 (45.5%)
Tao et al[21], 2003	China	Retrospective	23/23 (100%)	NA	41(31-71)	7 (33%)

ACS: Abdominal compartment syndrome; OA: Open abdomen; CG: Control group; HTG: Hypertriglyceridemia, ERCP: Endoscopic retrograde cholangiopancreatography; NA: Not available; IQR: Interquartile range.

Table 2 Demographic data of case reports or case series on abdominal compartment syndrome with acute pancreatitis

Ref.	Origin of study	Age (yr)/sex	Etiology of acute pancreatitis	Cumulative fluid balance after 24 h (mL)	Cumulative fluid balance after 48 h (mL)	IAP (mmHg) at diagnosis, after decompression	Organ support
Kawasaki et al[23], 2022	Japan	42/female	Alcohol-use	10000	NA	52, 30	Mechanical ventilation, RRT
Lee et al[27], 2019	Australia	38/male	Alcohol-use	6000		28, NA	Mechanical ventilation, vasopressors
Ikeda et al[28], 2019	Japan	65/female	Biliary	NA	NA	22, NA	Mechanical ventilation, vasopressors
McKenzie et al[31], 2017	United States	45/male	Biliary	NA	NA	> 20, NA	RRT, mechanical ventilation
Simoneau et al[30], 2014	Canada	67/male	Biliary	NA	NA	NA	Mechanical ventilation
Jacob et al[29], 2016	Australia	30/male	Alcohol-use	3930	3600	31, NA	RRT, mechanical ventilation, vasopressors
Jacob et al[29], 2016	Australia	40/male	Alcohol-use	4400	3600	33, NA	RRT, mechanical ventilation, vasopressors
Jacob et al[29], 2016	Australia	32/female	Alcohol-use	4560	3700	28, NA	Mechanical ventilation, vasopressors
Jacob et al[29], 2016	Australia	42/male	Alcohol-use	2500	7500	30, NA	RRT, mechanical ventilation, vasopressors
Jacob et al[29], 2016	Australia	28/male	Alcohol-use	4200	3650	28, NA	Mechanical ventilation, vasopressors
Siebig et al[25], 2008	Germany	56/male	Other	NA	NA	NA	Mechanical ventilation, vasopressors, ECMO
Siebig et al[25], 2008	Germany	49/male	Biliary	10000	7000	> 25, NA	Mechanical ventilation
Siebig et al[25], 2008	Germany	74/female	Post-surgery	NA	NA	> 20, NA	Mechanical ventilation
De Waele et al[26], 2005	Belgium	37/male	Alcohol-use	NA	NA	27, NA	Mechanical ventilation
Hu et al[24], 2013	China	27/male	Biliary	NA	NA	26, 15	Mechanical ventilation
Hu et al[24], 2013	China	60/female	HTG	NA	NA	25, 17	Mechanical ventilation
Hu et al[24], 2013	China	45/female	HTG	NA	NA	22, 14	Mechanical ventilation

IAP: Intraabdominal pressure; RRT: Renal replacement therapy; HTG: Hypertriglyceridemia; ERCP: Endoscopic retrograde cholangiopancreatography; ECMO: Extracorporeal membrane oxygenation; NA: Not available.

Table 3 Outcomes data from observational studies on abdominal compartment syndrome with acute pancreatitis

Ref.	IAP (mmHg), mean ± SD (range)		Organ dysfunction	Surgical decompression, including type of surgery	Time to intervention from hospitalization, diagnosis of ACS	Outcome	Post-decompressions complications
	Pre-surgery	Post-surgery
Husu et al[22], 2021	OA: 24 ± 4. CG: 21 ± 5	NA	SOFA: OA: 13 (11-14); CG: 12 (10-15). APACHE II: OA: 23 (17-29); CG: 18 (15-26)	ML in OA: 47/47 (100%)	60 (36-175) h, NA	90 d. mortality: OA: 19/40 (48%); CG: 3/21 (14%)
Smit et al[12], 2016	27 ± 3	18 ± 4	13/13 (100%). AKI: 100%. Respiratory failure: 100%. Shock: 100%	10 (76.9%). ML: 3 (33%). Subcostal full-thickness laparostomy: 7 (67%)	13.4 ± 6.5 d, 12 (2-176) h	Mortality: 7 (53.8%). LOS ICU: 48 d. GI ischemia: 61.5%	Bowel perforation or fistula: 46.2%
Peng et al[11], 2016	PCD: 31 (20-44). ML: 34 (20-51)	PCD: 19 (3-40). ML: 15 (2-24)	SOFA: PCD-11(2-23), ML-10 (3-24), decreased to 9 (2-24) and 9 (3-24)	ML: 61/273 (22.3%). PCD: 212/273 (77.7%)	PCD: 61 (2-101) h. ML: 64 (5-95) h	Mortality: PCD: 40 (19%); ML: 32 (52%). LOS hospital: 125 (21-627) d. LOS ICU: PCD: 14 d, ML: 21 d. Subsequent necrosectomy in PCD: 160 (75%), ML: 49 (80%)	Hepatic/portal/superior mesenteric vein/splanchnic vein thrombosis: ML: 3.2%, PCD: 0.9%. Bleeding: ML: 11.4%, PCD: 3.8%. Fistula: ML: 24.6%, PCD:18.4%
Davis et al[14], 2013	29.5	NA	AKI: 5 (31.3%). Respiratory failure: 11 (68.8%)	16 (35.6%). ML: 100%	NA, 3.1 h	Mortality: 4 (25%). LOS hospital: 146 d	Fistula: 62.5%. Wound infection: 62.5%. Incisional Hernia: 50%
Boone et al[15], 2013	42	NA	Mean APACHE: 23.3. Mean ranson: 9	12 (100%). ML: 12 (100%)	< 7 d in 9 patients, NA	Mortality: 6 (50%). Among survivors: LOS ICU: 37 ± 13 d; LOS hospital: 40.5 ± 25.2 d; IMV: 28 ± 11.4 d	Infection: 16%. Fistula: 16%
Leppäniemi et al[16], 2011	31 (23-45)	11 (1-20)	Mean SOFA: 12 (14-17)	Subcutaneous linea alba fasciotomy: 10 (100%). Subsequently, four required completion laparostomy	1-17 d (in 6 cases: < 48 h), NA	Mortality: 4 (40%). LOS hospital: 35 d; LOS ICU: 26 d	Hernia: 30%. Bleeding: 20%. Wound infection: 10%. Fistula: 10%
Deng et al[17], 2011	29 (23-38)	7.5 (6-18)	Resp failure: 8 (100%). AKI: 7 (87.5%). Hepatic: 7 (87.5%). Shock- 8 (100%)	8 (100%). ML plus continuous regional arterial infusion with protease inhibitors and antibiotics via a drug delivery system	3-9 d, NA	Mortality: 1(12.5%), LOS-ICU: 41 d, LOS-hospital- 117 d	Not mentioned
Mentula et al[18], 2010	31.5 (27-35)	NA	Resp failure: 24 (92%). AKI: 14 (54%). Shock: 23 (88%). Liver: 2 (8%)	26 (100%). ML: 18 (69.2%). Bilateral subcostal laparostomy: 1 (3.8%). SLAF: 7, 2/7 finally laparostomy	1 (0-29) d, NA	Mortality: 12/26 (46.2%)	Intrabdominal infection: 73%. Fistula: 19%
Chen et al[19], 2008	36.7 ± 5.3	18.3 ± 3.3	MODS: 18 (90%). Shock: 14 (70%)	8 (65%). PCD: 5 (25%). ML: 5 (25%). Combined: 3 (15%)	NA, 28.38 ± 2.29 h	Mortality: 15/20 (75%)	No complications reported
De Waele et al[20], 2005	> 25	NA	Resp failure: 20 (98%). AKI: 18 (86%). Shock: 19 (94%)	ML: 4/21. Indication for surgery: ACS: 4 (44.4%)	3, < 24 h	Mortality: 3/4 (75%). LOS ICU: 21 (10-37) d. LOS hospital: 42 (20-90) d. IMV: 15 (12.6) d	No complications reported
Tao et al[21], 2003	> 20	NA	Resp. failure: 100%. Shock: 100%	18/23 (78.2%). ML with drainage: 100%	NA, 5-22 h	Mortality: 3/18 (16.7%). Definitive closures 3-5 d	Hemorrhage: 42%. Abscess: 19.2%. Perforation/fistula: 3.8%

IAP: Intrabdominal pressure; SOFA: Sequential organ failure assessment; APACHE II: Acute physiology and chronic health evaluation; MODS: Muti-organ dysfunction syndrome; PCD: Percutaneous drainage; ML: Midline laparotomy; ACS: Abdominal compartment syndrome; OA: Open abdomen; CG: Control group; AKI: Acute kidney injury; SD: Standard deviation; SLAF: Subcutaneous line alba fasciotomy; ICU: Intensive care unit; LOS: Length of stay; IMV: Invasive mechanical ventilation; NA: Not available.

Table 4 Demographic data of case reports or case series on abdominal compartment syndrome with acute pancreatitis

Ref.	Type of surgery	Timing of the laparotomy from the diagnosis or admission	Abdomen closed after laparotomy	Management of open abdomen	Duration of open abdomen (d)	Outcome	Duration of ICU stay (d)	Duration of hospital stay (d)	Complications
Kawasaki et al[23], 2022	Midline fasciotomy	4 d	No	VAC	7	Alive	29	53	None
Lee et al[27], 2019	Midline laparotomy	24 h	No	VAC	75	Alive	44	121	None
Ikeda et al[28], 2019	Midline laparotomy	4 h	No	Open with mesh	2	Alive	NA	104	None
McKenzie et al[31], 2017	Midline laparotomy	24 h	No	VAC	10	Alive	NA	NA	None
Jacob et al[29], 2016	Midline laparotomy	5 h	No	VAC	21	Alive	NA	35	Pancreatic fistula: 4 (80%)
Jacob et al[29], 2016	Midline laparotomy	1 d	No	VAC	18	Alive	NA	54
Jacob et al[29], 2016	Midline laparotomy	4 d	No	VAC	15	Alive	22	43
Jacob et al[29], 2016	Midline laparotomy	2 d	No	VAC	18	Alive	30	49
Jacob et al[29], 2016	Midline laparotomy	2 d	No	VAC	10	Alive	32	62
Simoneau et al[30], 2014	Midline laparotomy	12 h	No	VAC and vicryl mesh	210	Alive	210	300	Pancreatic fistula
Hu et al[24], 2013	Transverse laparotomy	NA	NA	NA	NA	Alive	NA	71	None
Hu et al[24], 2013	Transverse laparotomy	NA	NA	NA	NA	Alive	NA	54	None
Hu et al[24], 2013	Transverse laparotomy	NA	NA	NA	NA	Alive	NA	31	None
Siebig et al[25], 2008	Midline laparotomy	1 d	Yes	NA	NA	Alive	NA	NA	None
Siebig et al[25], 2008	Midline laparotomy	1 d	No	VAC	NA	Death	NA	NA	Lung hemorrhage
Siebig et al[25], 2008	Midline laparotomy	< 24 h	No	VAC	90	Alive	NA	NA	None
De Waele et al[26], 2005	Midline laparotomy	24 h	No	VAC	29	Alive	NA	NA	Intraabdominal infection

VAC: Vacuum-assisted closure; NA: Not available; ICU: Intensive care unit.