Comparative Study of Minimally Invasive vs. Open Surgical Approaches inTreating Local Complications of Acute Pancreatitis

Background: Acute pancreatitis (AP) is a common gastrointestinal emergency with significant morbidity andmortality. Local complications, including pancreatic “fluid collections (PFC), necrosis, and vascular issues, oftenrequire surgical intervention. This study evaluates the surgical management of local complications of AP andassociated outcomes.Methods: A retrospective study was conducted at Department of General Surgery, AIIMS, Patna, India, involving80 patients who underwent surgical procedures for local complications of AP between 2021 and 2024. Patientswere selected using purposive sampling. Clinical, laboratory, and imaging data were collected, and surgicaloutcomes were assessed using the Clavien-Dindo classification. Data were analyzed using SPSS version 27.Results: Of the 80 patients, 52.5% were male and 47.5% were female. The leading cause of AP was ethanolconsumption (52.5%), followed by biliary causes (42.5%). Pseudocyst (40%) and acute necrotic collection(33.75%) were the most common complications. The body and tail of the pancreas were more frequently involved(67.5%) than the head (32.5%). Video-assisted retroperitoneal drainage (VARD) and open cysto-enterostomywere the most common procedures (17.5% each). Postoperative complications included surgical site infection(10%), hospital-acquired pneumonia (7.5%), and re-exploration (3.75%).Conclusion: Ethanol and biliary causes were the primary etiologies of AP. Minimally invasive procedures,including VARD, were associated with favorable outcomes and low complication rates. Early diagnosis and amultidisciplinary approach are essential for optimizing clinical outcomes.