Pancreatic necrosis: Complications and changing trend of treatment

Table 1 Peer-reviewed literature reports on the clinical outcomes of patients undergoing percutaneous catheter drainage

Author/year/country	Ref.	No. of patients	Mortality	Complications	Mortality
Jones/2016/ United States	[123]	69	PCD	N/A	6.5%
Navarrete/2016/Chile	[124]	17	PCD	1 = stent fracture, 1 = leak, 4, 2 = bleeding, 1 = pseudoaneurysm, 1 = venous oozing	0%
Sugimoto/2016/United States	[125]	39	PCD	New onset organ failure 01, 52, enterocutaneous fistula 41, 62	16%
Russell/2017/New Zealand	[126]	85	PCD	N/A	12%
Sleeman/2011/United States	[99]	63	PCD	Internal fistula n = 14 (23%), bleeding n = 2	8%
Ross/2010/United States	[127]	15	PCD	Immediate post-procedure complications; tachycardia and hypotension (n = 2), late complication, parenchymal infection (n = 1)	0%
Van Santvoort/2010/The Netherlands	[98]	88	PCD	Organ failure n = 5 (12%)1, n = 18 (40%)2, systemic complication n = 01, n = 1 (2%)2, nterocutaneous fistula/perforation n = 6 (14%)1, n = 10 (22%)2, pancreatic fistula n = 12 (28%)1, n = 17(38%)2, incisional hernia n = 3 (7%)1, n = 11 (24%)2, new onset diabetes n = 7 (16%)1, n = 17 (38%)2, pancreatic enzyme needed n = 3 (7%)1, n = 15 (33%)2, intraabdominal bleed n = 7 (16%)1	19%
Rocha/2009/United States	[128]	64	PCD	Infection 27%1, 35%2, 71%3, single organ failure 36%1, 12%2, 14%3. MOSF 64%1	12%
Becker/2009/Germany	[129]	7	PCD	Spontaneous duodenal perforation (1/7), pancreatico-colonic fistula (1/7), fistula to the retroperitoneal space (1/7), spontaneous gastric bleeding (1/7), exocrine insufficiency (2/7)	0
Bruennler/2008/United Kingdom	[130]	18	PCD	N/A	22%
Cheung/2005/Hong Kong	[131]	8	PCD	Intestinal fistula to abscess cavity (4/8), left subphrenic fluid collection (1/8)	12.5%
Risse/2004/France	[132]	6	PCD	1/61 Post-operative peritonitis, 1/61 40 °C fever 24 h, 1/61 insulin dependent DM, 1/61 Psuedocyst	0
Carter/2000/Scotland	[23]	10	PCD	N/A	20%
Freeny/1998/United States	[97]	34	PCD	N/A	N/A
Echenique/1988/United States	[133]	20	PCD	12/20 (renal failure × 2, bowel fistula × 10)	0

¹Indicates PCD associated variables.

²Indicates surgical procedure associated variables.

³Indicates endovascular approach associated variables. PCD: Percutaneous drainage; N/A: Not available; MOSF: Multiple organ system failure; DM: Diabetes mellitus.

Table 2 Peer-reviewed literature reports on the clinical outcomes of patients undergoing endoscopic transluminal necrosectomy

Author/year/country	Ref.	No. of patients	Modality	Complications	Overall successrate (%)	Mortality
Jones/2016/United States	[123]	69	ETN	N/A	N/A	6.5%
Oh/2016/Japan	[134]	25	ETN	20% (5/24), 4 self-limited abdominal pain, 1 minor bleeding	100% pain score improvement, p = 0.001	N/A
Sharaiha/2016/United States	[135]	124	ETN	Suprainfection n = 3, stent occlusion n = 2, stent migration n = 4, hemorrhage n = 1	N/A	0%
Huggett/2015/United Kingdom	[136]	19	ETN	Stent migration after necrosectomy 2/19, abdominal pain 1/19	N/A	26%
Schmidt/2015/Denmark	[137]	81	ETN	Death 1 (1%), bleeding from necrosis cavity 4 (5%), bleeding from transmural tract 4 (5%), pneumoperitoneum 4 (5%)	N/A	11%
Smoczyńsk/2016/Poland	[138]	56	ETN	Transmural stent displacement n = 11, GI perforation n = 11	N/A	0%
Siddiqui/2015/United States	[139]	68	ETN	Infection n = 4, bleeding n = 5	N/A	0%
Kumar/2014/United States	[103]	24	ETN	0/12 vs 8/12 (bleeding, enterocutaneous fistula and infection)	N/A	0
Smith/2014/United States	[140]	17	ETN	Bleeding n = 1, sepsis n = 1	N/A	5.8%
Saxena/2014/United States	[141]	5	ETN	Pseudocyst n = 1, stent displacement n = 1	N/A	0%
Rische/2013/Germany	[142]	31	ETN	Perforation of colon (n = 2); stent dislocation to jejunum (n = a), bleeding (n = 1)	83%	9.6%
Siddiqui/2013/United States	[143]	14	ETN	3/14 (perforation, pneumoperitonum, bacteremia)	N/A	7.1%
Ardengh/2013/Brazil	[144]	15	ETN	4 patients experienced bleeding (entry side (n = 3), inside cavity (n = 1), and worsening of infection (33.3%)	N/A	13.3%
Yasuda/2013/Japan	[145]	57	ETN	Bleeding (n = 5), perforation (n = 3), air embolism (n = 1)	75%	11%
Gardner/2011/United States	[116]	104	ETN	14/104 (Bacteremia, infected collection, moderate bleeding at puncture site, C. diff colitis, retrogastric perforation × 2, pneumoperitoneum × 3, balloon dilatation in retroperitoneum, massive bleeding during dilatation, periprocedural hypotension and cardiac arrest, anoxic brain injury, PEG site infection. bleeding (19/104)	N/A	5.7%
Varadarajulu/2011/United States	[146]	60	ETN	5/60	N/A	5%
Becker/2009/Germany	[129]	7	ETN	Spontaneous duodenal perforation (1/7), pancreatico-colonic fistula (1/7), fistula to the retroperitoneal space (1/7), spontaneous gastric bleeding (1/7), exocrine insufficiency (2/7)	N/A	0
Seifert/2009/Germany	[22]	93	ETN	Pseudocyst n = 11, bleeding n = 13, perforation n = 5, fistula n = 2, air embolism n = 2, multiorgan failure n = 2	80% Fairly satisfied	15.5%
Mathew/2008/United States	[95]	6	ETN	N/A	100%	N/A
Voermans/2007/The Netherlands	[147]	25	ETN	7/25 (bleeding). 1/25 (perforation of wall)	N/A	0
Schrover/2007/The Netherlands	[148]	8	ETN	Bleeding n = 1	N/A	12.5%
Charnley/2006/United Kingdom	[149]	13	ETN	N/A	N/A	15.3%
Bakker/2005/The Netherlands	[100]	20	ETN	New-onset diabetes 2 (22%)1 3 (50%)2, use of pancreatic enzymes 0 (0%)1, 3 (50%)2 persisting fluid collections 2 (22%)1 3 (50%)2, pancreatic fistula 1 (10%)1 7 (70%)2, enterocutaneous fistula 0 (0%)1 2 (20%)1, new-onset multiple organ failure 5 (50%)1 0 (0%)2	N/A	10%

¹Indicates ETN associated variables.

²Indicates surgical procedure associated variables. ETN: Endoscopic transluminal necrosectomy; N/A: Not available; PEG: Percutaneous endoscopic gastrostomy.