Retrospective analysis of surgical pancreatic necrosectomy outcomes in patients with and without obesity.

Abstract

Acute necrotizing pancreatitis is associated with high morbidity and mortality. This study aims to compare surgical necrosectomy outcomes in acute necrotizing pancreatitis between patients with and without obesity. A retrospective chart review was performed for all patients who underwent surgical necrosectomy via a minimally invasive approach or an open approach over a 10-year period at a large US healthcare system. Patients were divided into 2 groups: those with obesity (body mass index ≥30 kg/m²) and those without obesity (body mass index <30 kg/m²). The primary end point was the incidence of early complications or postoperative death within 30 and 90 days. The secondary end point was the incidence of long-term complications. In total, 80 patients were included with 36 (45%) with obesity, and 44 (55%) without obesity. A total of 52 patients (65%) had an open approach and 28 (35%) had an minimally invasive approach. The average age was 54.79 ± 15.25 years, and the median follow-up time was 83.5 days (interquartile range, 40.25-149.75 days). The median body mass index of the patient group with obesity was 34.55 kg/m² (interquartile range, 31.55-40.61), and that for the patient group without obesity was 25.97 kg/m² (interquartile range, 23.22-28.35 kg/m²) (P ≤ .0001). Days from admission to surgical intervention was longer in obese patients but it was not statistically significant (44.50 [interquartile range, 12-88] vs 27 [interquartile range, 15-42.5], P = .831). 30 and 90-day complication rates and mortality were similar between the groups. Operative outcomes of pancreatic necrosectomy in patients with obesity appears to be comparable with patients without obesity. Surgical pancreatic necrosectomy can be performed safely, effectively, and in a similar time frame regardless of the presence of obesity.