Surgical Intervention in Local Complications of Acute Pancreatitis:Indications and Clinical Outcomes

Abstract:Background: Acute pancreatitis (AP) can lead to several local complications, including pancreatic necrosis,pseudocysts, and walled-off necrosis, which occasionally necessitate surgical intervention. Early identification ofsurgical indications and understanding postoperative outcomes are essential for optimal patient management.Objectives: To analyze the indications for surgery in local complications of acute pancreatitis and to evaluate theclinical outcomes following operative management.Methods: This prospective observational study included 132 patients with acute pancreatitis who developed localcomplications and underwent surgical intervention at Department of General Surgery, Patna Medical College andHospital, Patna, Bihar, India between Oct 2019 and September 2020. Data were collected on demographic profile,type of local complication, indication for surgery, procedure performed, and postoperative outcomes.Results: The most common indication for surgery was infected pancreatic necrosis (45.4%), followed bysymptomatic pseudocysts (27.3%) and persistent abdominal sepsis due to walled-off necrosis (18.2%). Opennecrosectomy was the most frequently performed procedure. Postoperative morbidity occurred in 34.8% ofpatients, and mortality was recorded in 9.8%. Factors associated with poor outcomes included delayedpresentation, organ failure, and extensive necrosis.Conclusion: Surgical management of local complications of acute pancreatitis is often life-saving whenperformed based on strict indications. Early recognition and timely intervention significantly reduce morbidityand mortality, especially in patients with infected necrosis and systemic complications.