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<!DOCTYPE html> <html > <head> <meta charset="utf-8"> <meta rel="search" type="application/opensearchdescription+xml" href="/open_search.xml" title="Academia.edu"> <meta content="width=device-width, initial-scale=1" name="viewport"> <meta name="google-site-verification" content="bKJMBZA7E43xhDOopFZkssMMkBRjvYERV-NaN4R6mrs"> <meta name="csrf-param" content="authenticity_token" /> <meta name="csrf-token" content="0j6oRhoRDh6YfF8tXOZHEA7nhKB9TisUNEYSwFWoYl-EXV6lkRCUWsgPL5oRBX9qpqqdYzBDkjEp6jXfKkLL7g" /> <meta name="citation_title" content="Impact of the site of necrosis on outcome of acute pancreatitis" /> <meta name="citation_publication_date" content="2018/01/01" /> <meta name="citation_journal_title" content="JGH Open" /> <meta name="citation_author" content="Ajay Gulati" /> <meta name="twitter:card" content="summary" /> <meta name="twitter:url" content="https://www.academia.edu/122828906/Impact_of_the_site_of_necrosis_on_outcome_of_acute_pancreatitis" /> <meta name="twitter:title" content="Impact of the site of necrosis on outcome of acute pancreatitis" /> <meta name="twitter:description" content="Objecives: To compare the clinical outcome of patients with extrapancreatic necrosis (EXPN) alone with that of acute interstitial pancreatitis (AIP), pancreatic parenchymal necrosis (PPN) alone, and combined PPN and EXPN. Background: There are only a" /> <meta name="twitter:image" content="https://0.academia-photos.com/310680093/154619458/144236398/s200_ajay.gulati.jpeg" /> <meta property="fb:app_id" content="2369844204" /> <meta property="og:type" content="article" /> <meta property="og:url" content="https://www.academia.edu/122828906/Impact_of_the_site_of_necrosis_on_outcome_of_acute_pancreatitis" /> <meta property="og:title" content="Impact of the site of necrosis on outcome of acute pancreatitis" /> <meta property="og:image" content="http://a.academia-assets.com/images/open-graph-icons/fb-paper.gif" /> <meta property="og:description" content="Objecives: To compare the clinical outcome of patients with extrapancreatic necrosis (EXPN) alone with that of acute interstitial pancreatitis (AIP), pancreatic parenchymal necrosis (PPN) alone, and combined PPN and EXPN. Background: There are only a" /> <meta property="article:author" content="https://independent.academia.edu/AjayGulati11" /> <meta name="description" content="Objecives: To compare the clinical outcome of patients with extrapancreatic necrosis (EXPN) alone with that of acute interstitial pancreatitis (AIP), pancreatic parenchymal necrosis (PPN) alone, and combined PPN and EXPN. Background: There are only a" /> <title>(PDF) Necrosis Site Affects Acute Pancreatitis Outcomes</title> <link rel="canonical" href="https://www.academia.edu/122828906/Impact_of_the_site_of_necrosis_on_outcome_of_acute_pancreatitis" /> <script async src="https://www.googletagmanager.com/gtag/js?id=G-5VKX33P2DS"></script> <script> window.dataLayer = window.dataLayer || []; function gtag(){dataLayer.push(arguments);} gtag('js', new Date()); gtag('config', 'G-5VKX33P2DS', { cookie_domain: 'academia.edu', send_page_view: false, }); gtag('event', 'page_view', { 'controller': "single_work", 'action': "show", 'controller_action': 'single_work#show', 'logged_in': 'false', 'edge': 'unknown', // Send nil if there is no A/B test bucket, in case some records get logged // with missing data - that way we can distinguish between the two cases. // ab_test_bucket should be of the form <ab_test_name>:<bucket> 'ab_test_bucket': null, }) </script> <script> var $controller_name = 'single_work'; var 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Gulati","url":"https://independent.academia.edu/AjayGulati11"}],"contributor":[],"dateCreated":"2024-08-13","datePublished":"2018-01-01","headline":"Impact of the site of necrosis on outcome of acute pancreatitis","image":"https://attachments.academia-assets.com/117410529/thumbnails/1.jpg","inLanguage":"en","keywords":["Gastroenterology","Pancreatitis","Medicine","Internal Medicine","Acute Pancreatitis","Necrosis"],"publication":"JGH Open","publisher":{"@context":"https://schema.org","@type":"Organization","name":"Wiley"},"sourceOrganization":[{"@context":"https://schema.org","@type":"EducationalOrganization","name":null}],"thumbnailUrl":"https://attachments.academia-assets.com/117410529/thumbnails/1.jpg","url":"https://www.academia.edu/122828906/Impact_of_the_site_of_necrosis_on_outcome_of_acute_pancreatitis"}</script><style type="text/css">@media(max-width: 567px){:root{--token-mode: Rebrand;--dropshadow: 0 2px 4px 0 #22223340;--primary-brand: #0645b1;--error-dark: 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{"work":{"id":122828906,"created_at":"2024-08-13T01:08:16.762-07:00","from_world_paper_id":258125279,"updated_at":"2025-02-03T13:05:05.375-08:00","_data":{"publisher":"Wiley","ai_title_tag":"Necrosis Site Affects Acute Pancreatitis Outcomes","grobid_abstract":"Objecives: To compare the clinical outcome of patients with extrapancreatic necrosis (EXPN) alone with that of acute interstitial pancreatitis (AIP), pancreatic parenchymal necrosis (PPN) alone, and combined PPN and EXPN. Background: There are only a few studies in the literature in which EXPN has been recently recognized as a subtype of acute necrotizing pancreatitis (ANP), with a better prognosis. Methods: We analyzed clinical data and outcome variables of 411 consecutive acute pancreatitis (AP) patients between January 2012 and December 2014. Contrastenhanced computed tomography (CECT) images of each patient were reviewed and characterized as AIP or ANP. Patients with ANP were divided into EXPN alone, PPN alone, and combined PPN and EXPN. Outcome variables were then compared between these groups. Results: Of the 411 patients, 74 (18%) had AIP, and 337 (82%) had ANP. Patients with EXPN alone (n = 40; 11.8%) had similar outcomes as patients with PPN alone (n = 12; 3.5%); however, their outcome was worse than that of patients with AIP, with a higher frequency of persistent organ failure (POF), need for percutaneous catheter drainage (PCD), and longer length of hospitalization (LOH). Patients with combined PPN and EXPN (n = 285; 84.7%) had the worst clinical course, with higher frequency of POF, infected necrosis, intervention requirement, and longer LOH. Conclusion: Patients with combined PPN and EXPN have a severe disease course with the worst clinical outcomes; patients with AIP patients have the most benign course, while patients with EXPN alone stand between the two extremes of disease course with an intermediate grade of severity.","publication_date":"2018,,","publication_name":"JGH Open","grobid_abstract_attachment_id":"117410529"},"document_type":"paper","pre_hit_view_count_baseline":null,"quality":"high","language":"en","title":"Impact of the site of necrosis on outcome of acute pancreatitis","broadcastable":false,"draft":null,"has_indexable_attachment":true,"indexable":true}}["work"]; window.loswp.workCoauthors = [310680093]; window.loswp.locale = "en"; window.loswp.countryCode = "SG"; window.loswp.cwvAbTestBucket = ""; window.loswp.designVariant = "ds_vanilla"; window.loswp.fullPageMobileSutdModalVariant = "full_page_mobile_sutd_modal"; window.loswp.useOptimizedScribd4genScript = false; window.loginModal = {}; window.loginModal.appleClientId = 'edu.academia.applesignon'; window.userInChina = "false";</script><script defer="" src="https://accounts.google.com/gsi/client"></script><div class="ds-loswp-container"><div class="ds-work-card--grid-container"><div class="ds-work-card--container js-loswp-work-card"><div class="ds-work-card--cover"><div class="ds-work-cover--wrapper"><div class="ds-work-cover--container"><button class="ds-work-cover--clickable js-swp-download-button" data-signup-modal="{"location":"swp-splash-paper-cover","attachmentId":117410529,"attachmentType":"pdf"}"><div class="ds-work-cover--blank-cover"><div class="ds-work-cover--blank-cover--title">Impact of the site of necrosis on outcome of acute pancreatitis</div><div class="ds-work-cover--blank-cover--page-count">5 pages</div></div><img alt="PDF Icon" class="ds-work-cover--file-icon" src="//a.academia-assets.com/images/single_work_splash/adobe_icon.svg" /><div class="ds-work-cover--hover-container"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">download</span><p>Download Free PDF</p></div><div class="ds-work-cover--ribbon-container">Download Free PDF</div><div class="ds-work-cover--ribbon-triangle"></div></button></div></div></div><div class="ds-work-card--work-information"><h1 class="ds-work-card--work-title">Impact of the site of necrosis on outcome of acute pancreatitis</h1><div class="ds-work-card--work-authors ds-work-card--detail"><a class="ds-work-card--author js-wsj-grid-card-author ds2-5-body-md ds2-5-body-link" data-author-id="310680093" href="https://independent.academia.edu/AjayGulati11"><img alt="Profile image of Ajay Gulati" class="ds-work-card--author-avatar" src="https://0.academia-photos.com/310680093/154619458/144236398/s65_ajay.gulati.jpeg" />Ajay Gulati</a></div><div class="ds-work-card--detail"><p class="ds-work-card--detail ds2-5-body-sm">2018, JGH Open</p><div class="ds-work-card--work-metadata"><div class="ds-work-card--work-metadata__stat"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">visibility</span><p class="ds2-5-body-sm" id="work-metadata-view-count">…</p></div><div class="ds-work-card--work-metadata__stat"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">description</span><p class="ds2-5-body-sm">5 pages</p></div><div class="ds-work-card--work-metadata__stat"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">link</span><p class="ds2-5-body-sm">1 file</p></div></div><script>(async () => { const workId = 122828906; const worksViewsPath = "/v0/works/views?subdomain_param=api&work_ids%5B%5D=122828906"; const getWorkViews = async (workId) => { const response = await fetch(worksViewsPath); if (!response.ok) { throw new Error('Failed to load work views'); } const data = await response.json(); return data.views[workId]; }; // Get the view count for the work - we send this immediately rather than waiting for // the DOM to load, so it can be available as soon as possible (but without holding up // the backend or other resource requests, because it's a bit expensive and not critical). const viewCount = await getWorkViews(workId); const updateViewCount = (viewCount) => { try { const viewCountNumber = parseInt(viewCount, 10); if (viewCountNumber === 0) { // Remove the whole views element if there are zero views. document.getElementById('work-metadata-view-count')?.parentNode?.remove(); return; } const commaizedViewCount = viewCountNumber.toLocaleString(); const viewCountBody = document.getElementById('work-metadata-view-count'); if (!viewCountBody) { throw new Error('Failed to find work views element'); } viewCountBody.textContent = `${commaizedViewCount} views`; } catch (error) { // Remove the whole views element if there was some issue parsing. document.getElementById('work-metadata-view-count')?.parentNode?.remove(); throw new Error(`Failed to parse view count: ${viewCount}`, error); } }; // If the DOM is still loading, wait for it to be ready before updating the view count. if (document.readyState === "loading") { document.addEventListener('DOMContentLoaded', () => { updateViewCount(viewCount); }); // Otherwise, just update it immediately. } else { updateViewCount(viewCount); } })();</script></div><p class="ds-work-card--work-abstract ds-work-card--detail ds2-5-body-md">Objecives: To compare the clinical outcome of patients with extrapancreatic necrosis (EXPN) alone with that of acute interstitial pancreatitis (AIP), pancreatic parenchymal necrosis (PPN) alone, and combined PPN and EXPN. Background: There are only a few studies in the literature in which EXPN has been recently recognized as a subtype of acute necrotizing pancreatitis (ANP), with a better prognosis. Methods: We analyzed clinical data and outcome variables of 411 consecutive acute pancreatitis (AP) patients between January 2012 and December 2014. Contrastenhanced computed tomography (CECT) images of each patient were reviewed and characterized as AIP or ANP. Patients with ANP were divided into EXPN alone, PPN alone, and combined PPN and EXPN. Outcome variables were then compared between these groups. Results: Of the 411 patients, 74 (18%) had AIP, and 337 (82%) had ANP. Patients with EXPN alone (n = 40; 11.8%) had similar outcomes as patients with PPN alone (n = 12; 3.5%); however, their outcome was worse than that of patients with AIP, with a higher frequency of persistent organ failure (POF), need for percutaneous catheter drainage (PCD), and longer length of hospitalization (LOH). Patients with combined PPN and EXPN (n = 285; 84.7%) had the worst clinical course, with higher frequency of POF, infected necrosis, intervention requirement, and longer LOH. Conclusion: Patients with combined PPN and EXPN have a severe disease course with the worst clinical outcomes; patients with AIP patients have the most benign course, while patients with EXPN alone stand between the two extremes of disease course with an intermediate grade of severity.</p><div class="ds-work-card--button-container"><button class="ds2-5-button js-swp-download-button" data-signup-modal="{"location":"continue-reading-button--work-card","attachmentId":117410529,"attachmentType":"pdf","workUrl":"https://www.academia.edu/122828906/Impact_of_the_site_of_necrosis_on_outcome_of_acute_pancreatitis"}">See full PDF</button><button class="ds2-5-button ds2-5-button--secondary js-swp-download-button" data-signup-modal="{"location":"download-pdf-button--work-card","attachmentId":117410529,"attachmentType":"pdf","workUrl":"https://www.academia.edu/122828906/Impact_of_the_site_of_necrosis_on_outcome_of_acute_pancreatitis"}"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">download</span>Download PDF</button></div><div class="ds-signup-banner-trigger-container"><div class="ds-signup-banner-trigger ds-signup-banner-trigger-control"></div></div><div class="ds-signup-banner ds-signup-banner-control"><div id="ds-signup-banner-close-button"><button class="ds2-5-button ds2-5-button--secondary ds2-5-button--inverse"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">close</span></button></div><div class="ds-signup-banner-ctas"><img src="//a.academia-assets.com/images/academia-logo-capital-white.svg" /><h4 class="ds2-5-heading-serif-sm">Sign up for access to the world's latest research</h4><button class="ds2-5-button ds2-5-button--inverse ds2-5-button--full-width js-swp-download-button" data-signup-modal="{"location":"signup-banner"}">Sign up for free<span class="material-symbols-outlined" style="font-size: 20px" translate="no">arrow_forward</span></button></div><div class="ds-signup-banner-divider"></div><div class="ds-signup-banner-reasons"><div class="ds-signup-banner-reasons-item"><span class="material-symbols-outlined" style="font-size: 24px" translate="no">check</span><span>Get notified about relevant papers</span></div><div class="ds-signup-banner-reasons-item"><span class="material-symbols-outlined" style="font-size: 24px" translate="no">check</span><span>Save papers to use in your research</span></div><div class="ds-signup-banner-reasons-item"><span class="material-symbols-outlined" style="font-size: 24px" translate="no">check</span><span>Join the discussion with peers</span></div><div class="ds-signup-banner-reasons-item"><span class="material-symbols-outlined" style="font-size: 24px" translate="no">check</span><span>Track your impact</span></div></div></div><script>(() => { // Set up signup banner show/hide behavior: // 1. 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We evaluated a large cohort of patients with IP and compared data with those from patients with extrapancreatic necrosis (EXPN). METHODS: We evaluated 149 consecutive patients with IP admitted over a 2.5-year period. Transferred patients were excluded. We collected data on age, Charlson comorbidity score (CCI), measures of severity on admission or within 24 hours (Acute Physiology and Chronic Health Evaluation II, bedside index for severity of acute pancreatitis scores), persistent (Ͼ48 h) systemic inflammatory response syndrome, persistent organ failure, need for intensive care unit, length of hospital stay (in days), and mortality. We also analyzed levels of severity among those with IP and EXPN. Statistical analysis was performed using SAS version 9.1 (Cary, NC). RESULTS: Among the patients with IP, the median CCI score was 1, the median Acute Physiology and Chronic Health Evaluation II score was 7, and the median bedside index for severity of acute pancreatitis score was 1. In addition, the median length of hospital stay was only 4 days; only 1% had persistent organ failure and only 1% to 2% required intervention. The mortality rate of IP was 3%; it was associated significantly with comorbidity (the median CCI scores of nonsurvivors and survivors was 4 and 1, respectively, P ϭ .003). Patients with EXPN had greater levels of disease severity, compared with patients with IP. CONCLUSIONS: IP is severe in only 1% to 3% of patients; mortality of IP is associated strongly with comorbidity. EXPN is more frequently severe than IP; EXPN must be distinguished from IP in clinical studies.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"An Assessment of the Severity of Interstitial Pancreatitis","attachmentId":50154801,"attachmentType":"pdf","work_url":"https://www.academia.edu/3733164/An_Assessment_of_the_Severity_of_Interstitial_Pancreatitis","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/3733164/An_Assessment_of_the_Severity_of_Interstitial_Pancreatitis"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="1" data-entity-id="117401642" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/117401642/Sa1496_Two_Decade_Overview_of_the_Nationwide_Trend_of_Acute_Pancreatitis_Hospitalization_in_Hospital_Mortality_Rate_and_Predictive_Factors_of_in_Hospital_Mortality">Sa1496 Two Decade Overview of the Nationwide Trend of Acute Pancreatitis Hospitalization, in-Hospital Mortality Rate and Predictive Factors of in-Hospital Mortality</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="306753184" href="https://independent.academia.edu/mazenjamal2">mazen jamal</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Gastroenterology, 2012</p><p class="ds-related-work--abstract ds2-5-body-sm">(17%), trauma (4%) and others (5%). Eighty patients (72%) had acute necrotizing pancreatitis, 17 (15%) patients had only PPN and 14 (13%) patients had no pancreatic or peripancreatic necrosis. Ninety three (84%) patients had PPN and of these 19 (20%) patients had extensive PPN, 17 (15%) patients had only PPN with no pancreatic necrosis and 18 (16%) patients had no PPN. Twenty three of 111 (20%) patients died whereas surgery or radiological/ endoscopic intervention was needed in 11 (10%) and 43 (39%) patients respectively. Forty (43%) of patients with PPN required radiological or endoscopic intervention whereas 3 /18 (16.6%) of patients without PPN required radiological or endoscopic intervention (p=0.03). Eleven (12%) of patients with PPN required surgery whereas none of the patients without PPN required surgery (p>0.05). Twenty (22%) patients with PPN succumbed to the illness whereas 3 /18 (16%) patients without PPN expired (p>0.05). Extensive PPN had significant association with the need for surgery (p=0.009). On comparison of patients with PPN only with the patients having no pancreatic or peripancreatic necrosis, there was no significant difference in the mortality and need for surgery between the two groups (p=0.39 and 0.37 respectively). However, 6/17 (35%) patients with PPN only required radiological/endoscopic intervention whereas 1/14 (7%) patients with no necrosis required intervention (p=0.06). Conclusion: In acute pancreatitis, presence of PPN may predict the need for intervention, with patients having extensive PPN more likely to undergo surgery.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Sa1496 Two Decade Overview of the Nationwide Trend of Acute Pancreatitis Hospitalization, in-Hospital Mortality Rate and Predictive Factors of in-Hospital Mortality","attachmentId":113268101,"attachmentType":"pdf","work_url":"https://www.academia.edu/117401642/Sa1496_Two_Decade_Overview_of_the_Nationwide_Trend_of_Acute_Pancreatitis_Hospitalization_in_Hospital_Mortality_Rate_and_Predictive_Factors_of_in_Hospital_Mortality","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/117401642/Sa1496_Two_Decade_Overview_of_the_Nationwide_Trend_of_Acute_Pancreatitis_Hospitalization_in_Hospital_Mortality_Rate_and_Predictive_Factors_of_in_Hospital_Mortality"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="2" data-entity-id="9744434" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/9744434/Organ_Failure_and_Infection_of_Pancreatic_Necrosis_as_Determinants_of_Mortality_in_Patients_With_Acute_Pancreatitis">Organ Failure and Infection of Pancreatic Necrosis as Determinants of Mortality in Patients With Acute Pancreatitis</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="23430533" href="https://auckland.academia.edu/SatyanarayanShanbhag">Satyanarayan Shanbhag</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Gastroenterology, 2010</p><p class="ds-related-work--abstract ds2-5-body-sm">This article has an accompanying continuing medical education activity on page e13. Learning Objective: Upon completion of this exercise, successful learners will be able to recognize the major determinants of severity for acute pancreatitis.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Organ Failure and Infection of Pancreatic Necrosis as Determinants of Mortality in Patients With Acute Pancreatitis","attachmentId":47660052,"attachmentType":"pdf","work_url":"https://www.academia.edu/9744434/Organ_Failure_and_Infection_of_Pancreatic_Necrosis_as_Determinants_of_Mortality_in_Patients_With_Acute_Pancreatitis","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/9744434/Organ_Failure_and_Infection_of_Pancreatic_Necrosis_as_Determinants_of_Mortality_in_Patients_With_Acute_Pancreatitis"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="3" data-entity-id="84960873" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/84960873/Risk_factors_and_outcomes_of_infected_pancreatic_necrosis_Retrospective_cohort_of_148_patients_admitted_to_the_ICU_for_acute_pancreatitis">Risk factors and outcomes of infected pancreatic necrosis: Retrospective cohort of 148 patients admitted to the ICU for acute pancreatitis</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="38067281" href="https://independent.academia.edu/Fr%C3%A9d%C3%A9ricDouane">Frédéric Douane</a></div><p class="ds-related-work--metadata ds2-5-body-xs">United European Gastroenterology Journal, 2018</p><p class="ds-related-work--abstract ds2-5-body-sm">Objective: The primary objective of this article is to identify risk factors for infected pancreatic necrosis (IPN) in patients admitted to the intensive care unit (ICU) for severe acute pancreatitis. We also described outcomes of IPN. Background: Acute pancreatitis is common and associated with multiple, potentially life-threatening complications. Over the last decade, minimally invasive procedures have been developed to treat IPN. Methods: We retrospectively studied consecutive patients admitted for severe acute pancreatitis to the ICUs of the Nantes University Hospital in France, between 2012 and 2015. Logistic regression was used to evaluate potential associations linking IPN to baseline patient characteristics and outcomes. Results: Of the 148 included patients, 26 (17.6%) died. IPN developed in 62 (43%) patients and consistently required radiological, endoscopic, and/or surgical intervention. By multivariate analysis, factors associated with IPN were number of organ failure (OF) (for ! 3: OR, 28.67 (6.23-131.96), p < 0.001) and portosplenomesenteric venous thrombosis (OR, 8.16 (3.06-21.76)). Conclusion: IPN occurred in nearly half our ICU patients with acute pancreatitis and consistently required interventional therapy. Number of OFs and portosplenomesenteric venous thrombosis were significantly associated with IPN. Early management of OF may reduce IPN incidence, and management of portosplenomesenteric venous thrombosis should be investigated.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Risk factors and outcomes of infected pancreatic necrosis: Retrospective cohort of 148 patients admitted to the ICU for acute pancreatitis","attachmentId":89808745,"attachmentType":"pdf","work_url":"https://www.academia.edu/84960873/Risk_factors_and_outcomes_of_infected_pancreatic_necrosis_Retrospective_cohort_of_148_patients_admitted_to_the_ICU_for_acute_pancreatitis","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/84960873/Risk_factors_and_outcomes_of_infected_pancreatic_necrosis_Retrospective_cohort_of_148_patients_admitted_to_the_ICU_for_acute_pancreatitis"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="4" data-entity-id="84273749" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/84273749/Dual_Modality_Drainage_for_Symptomatic_Walled_Off_Pancreatic_Necrosis_Reduces_Length_of_Hospitalization_Radiological_Procedures_and_Number_of_Endoscopies_Compared_to_Standard_Percutaneous_Drainage">Dual Modality Drainage for Symptomatic Walled-Off Pancreatic Necrosis Reduces Length of Hospitalization, Radiological Procedures, and Number of Endoscopies Compared to Standard Percutaneous Drainage</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="38200980" href="https://independent.academia.edu/RKozarek">Richard Kozarek</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Journal of Gastrointestinal Surgery, 2011</p><p class="ds-related-work--abstract ds2-5-body-sm">Background Symptomatic walled-off pancreatic necrosis (WOPN) treated with dual modality endoscopic and percutaneous drainage (DMD) has been shown to decrease length of hospitalization (LOH) and use of radiological resources in comparison to standard percutaneous drainage (SPD). Aim The aim of this study is to demonstrate that as the cohort of DMD and SPD patients expand, the original conclusions are durable. Methods The database of patients receiving treatment for WOPN between January 2006 and April 2011 was analyzed retrospectively. Patients One hundred two patients with symptomatic WOPN who had no previous drainage procedures were evaluated: 49 with DMD and 46 with SPD; 7 were excluded due to a salvage procedure. Results Patient characteristics including age, sex, etiology of pancreatitis, and severity of disease based on computed tomographic severity index were indistinguishable between the two cohorts. The DMD cohort had shorter LOH, time until removal of percutaneous drains, fewer CT scans, drain studies, and endoscopic retrograde cholangiopancreatography (ERCPs; p<0.05 for all). There were 12 identifiable complications during DMD, which were successfully treated without the need for surgery. The 30-day mortality in DMD was 4% (one multi-system organ failure and one out of the hospital with congestive heart failure). Three patients receiving SPD had surgery, and three (7%) died in the hospital. Conclusion DMD for symptomatic WOPN reduces LOH, radiological procedures, and number of ERCPs compared to SPD.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Dual Modality Drainage for Symptomatic Walled-Off Pancreatic Necrosis Reduces Length of Hospitalization, Radiological Procedures, and Number of Endoscopies Compared to Standard Percutaneous Drainage","attachmentId":89353732,"attachmentType":"pdf","work_url":"https://www.academia.edu/84273749/Dual_Modality_Drainage_for_Symptomatic_Walled_Off_Pancreatic_Necrosis_Reduces_Length_of_Hospitalization_Radiological_Procedures_and_Number_of_Endoscopies_Compared_to_Standard_Percutaneous_Drainage","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/84273749/Dual_Modality_Drainage_for_Symptomatic_Walled_Off_Pancreatic_Necrosis_Reduces_Length_of_Hospitalization_Radiological_Procedures_and_Number_of_Endoscopies_Compared_to_Standard_Percutaneous_Drainage"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="5" data-entity-id="29039595" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/29039595/What_is_the_outcome_for_patients_presenting_with_severe_acute_pancreatitis_requiring_a_hospital_stay_of_more_than_one_month">What is the outcome for patients presenting with severe acute pancreatitis requiring a hospital stay of more than one month?</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="54757970" href="https://independent.academia.edu/GrimaudJeanCharles">Jean-Charles Grimaud</a><span>, </span><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="54862103" href="https://independent.academia.edu/JulieGigout">Julie Gigout</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Gastroenterologie Clinique Et Biologique, 2009</p><p class="ds-related-work--abstract ds2-5-body-sm">Objective. -The aim of this study was to investigate the clinical progression of patients who had severe acute pancreatitis (AP) and a stay in hospital of more than a month. Methods. -A total of 24 patients (median age: 57 years) were included in this eight-year retrospective study. Cure was defined as the restoration of the pancreatic parenchyma, and the disappearance of all pseudocysts and pancreatic fistulae. Data including the duration of hospital stay, disease severity and pancreatic sequelae were also collected.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"What is the outcome for patients presenting with severe acute pancreatitis requiring a hospital stay of more than one month?","attachmentId":49492662,"attachmentType":"pdf","work_url":"https://www.academia.edu/29039595/What_is_the_outcome_for_patients_presenting_with_severe_acute_pancreatitis_requiring_a_hospital_stay_of_more_than_one_month","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/29039595/What_is_the_outcome_for_patients_presenting_with_severe_acute_pancreatitis_requiring_a_hospital_stay_of_more_than_one_month"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="6" data-entity-id="98405613" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/98405613/Infected_pancreatic_necrosis_outcomes_and_clinical_predictors_of_mortality_A_post_hoc_analysis_of_the_MANCTRA_1_international_study">Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="62447847" href="https://ucc-ar.academia.edu/DianaAlejandraPantojaPachajoa">Diana Alejandra Pantoja Pachajoa</a></div><p class="ds-related-work--abstract ds2-5-body-sm">The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intraabdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p < 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990).</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study","attachmentId":99765694,"attachmentType":"pdf","work_url":"https://www.academia.edu/98405613/Infected_pancreatic_necrosis_outcomes_and_clinical_predictors_of_mortality_A_post_hoc_analysis_of_the_MANCTRA_1_international_study","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/98405613/Infected_pancreatic_necrosis_outcomes_and_clinical_predictors_of_mortality_A_post_hoc_analysis_of_the_MANCTRA_1_international_study"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="7" data-entity-id="88421953" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/88421953/CT_Guided_Percutaneous_Catheter_Drainage_of_Acute_Infectious_Necrotizing_Pancreatitis_Assessment_of_Effectiveness_and_Safety">CT-Guided Percutaneous Catheter Drainage of Acute Infectious Necrotizing Pancreatitis: Assessment of Effectiveness and Safety</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="240212125" href="https://independent.academia.edu/StanleyAshley3">Stanley Ashley</a></div><p class="ds-related-work--metadata ds2-5-body-xs">American Journal of Roentgenology, 2012</p><p class="ds-related-work--abstract ds2-5-body-sm">Va s c u l a r a n d I nt e r ve nt io n a l R a d io l og y • O r ig i n a l R e s e a rc h</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"CT-Guided Percutaneous Catheter Drainage of Acute Infectious Necrotizing Pancreatitis: Assessment of Effectiveness and Safety","attachmentId":92395907,"attachmentType":"pdf","work_url":"https://www.academia.edu/88421953/CT_Guided_Percutaneous_Catheter_Drainage_of_Acute_Infectious_Necrotizing_Pancreatitis_Assessment_of_Effectiveness_and_Safety","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/88421953/CT_Guided_Percutaneous_Catheter_Drainage_of_Acute_Infectious_Necrotizing_Pancreatitis_Assessment_of_Effectiveness_and_Safety"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="8" data-entity-id="31728175" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/31728175/Systematic_review_of_percutaneous_catheter_drainage_as_primary_treatment_for_necrotizing_pancreatitis_Br_J_Surg_2011_98_18_27_">Systematic review of percutaneous catheter drainage as primary treatment for necrotizing pancreatitis (Br J Surg 2011; 98: 18-27)</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="61055488" href="https://independent.academia.edu/HeinGooszen">Hein Gooszen</a></div><p class="ds-related-work--metadata ds2-5-body-xs">British Journal of Surgery, 2011</p><p class="ds-related-work--abstract ds2-5-body-sm">The role of percutaneous catheter drainage (PCD) in patients with (infected) necrotizing pancreatitis was evaluated. Methods: A systematic literature search was performed. Inclusion criteria were: consecutive cohort of patients with necrotizing pancreatitis undergoing PCD as primary treatment for peripancreatic collections; indication for PCD either (suspected) infected necrosis or symptomatic sterile pancreatic necrosis; and outcomes reported to include percentage of infected peripancreatic collections, need for additional surgical necrosectomy, complications and deaths. Exclusion criteria were: cohort of fewer than five patients; cohort included patients with chronic pancreatitis; selected subgroup of patients with acute pancreatitis studied, such as those with pseudocysts, pancreatic abscesses and/or exclusively sterile pancreatic necrosis; and cohort in which PCD was combined with another minimally invasive strategy and results for PCD alone not reported separately. Results: Eleven studies, including 384 patients, fulfilled the inclusion criteria. Only one study was a randomized controlled trial; most others were retrospective case series. Four studies reported on the presence of organ failure before PCD; this occurred in 67•2 per cent of 116 patients. Infected necrosis was proven in 271 (70•6 per cent) of 384 patients. No additional surgical necrosectomy was required after PCD in 214 (55•7 per cent) of 384 patients. Complications consisted mostly of internal and external pancreatic fistulas. The overall mortality rate was 17•4 per cent (67 of 384 patients). Nine of 11 studies reported mortality separately for patients with infected necrosis undergoing PCD; the mortality rate in this group was 15•4 per cent (27 of 175). A considerable number of patients can be treated with PCD without the need for surgical necrosectomy.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Systematic review of percutaneous catheter drainage as primary treatment for necrotizing pancreatitis (Br J Surg 2011; 98: 18-27)","attachmentId":52039304,"attachmentType":"pdf","work_url":"https://www.academia.edu/31728175/Systematic_review_of_percutaneous_catheter_drainage_as_primary_treatment_for_necrotizing_pancreatitis_Br_J_Surg_2011_98_18_27_","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/31728175/Systematic_review_of_percutaneous_catheter_drainage_as_primary_treatment_for_necrotizing_pancreatitis_Br_J_Surg_2011_98_18_27_"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="9" data-entity-id="27139552" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/27139552/Revised_Atlanta_and_Determinant_Based_Classification_Application_in_a_Prospective_Cohort_of_Acute_Pancreatitis_Patients">Revised Atlanta and Determinant-Based Classification: Application in a Prospective Cohort of Acute Pancreatitis Patients</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="51199406" href="https://mitpune.academia.edu/DhirajYadav">Dhiraj Yadav</a></div><p class="ds-related-work--metadata ds2-5-body-xs">The American Journal of Gastroenterology, 2013</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Revised Atlanta and Determinant-Based Classification: Application in a Prospective Cohort of Acute Pancreatitis Patients","attachmentId":47388582,"attachmentType":"pdf","work_url":"https://www.academia.edu/27139552/Revised_Atlanta_and_Determinant_Based_Classification_Application_in_a_Prospective_Cohort_of_Acute_Pancreatitis_Patients","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/27139552/Revised_Atlanta_and_Determinant_Based_Classification_Application_in_a_Prospective_Cohort_of_Acute_Pancreatitis_Patients"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div></div></div><div class="ds-sticky-ctas--wrapper js-loswp-sticky-ctas hidden"><div class="ds-sticky-ctas--grid-container"><div class="ds-sticky-ctas--container"><button class="ds2-5-button js-swp-download-button" data-signup-modal="{"location":"continue-reading-button--sticky-ctas","attachmentId":117410529,"attachmentType":"pdf","workUrl":null}">See full PDF</button><button class="ds2-5-button ds2-5-button--secondary js-swp-download-button" data-signup-modal="{"location":"download-pdf-button--sticky-ctas","attachmentId":117410529,"attachmentType":"pdf","workUrl":null}"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">download</span>Download PDF</button></div></div></div><div class="ds-below-fold--grid-container"><div class="ds-work--container js-loswp-embedded-document"><div class="attachment_preview" data-attachment="Attachment_117410529" style="display: none"><div class="js-scribd-document-container"><div class="scribd--document-loading js-scribd-document-loader" style="display: block;"><img alt="Loading..." src="//a.academia-assets.com/images/loaders/paper-load.gif" /><p>Loading Preview</p></div></div><div style="text-align: center;"><div class="scribd--no-preview-alert js-preview-unavailable"><p>Sorry, preview is currently unavailable. You can download the paper by clicking the button above.</p></div></div></div></div><div class="ds-sidebar--container js-work-sidebar"><div class="ds-related-content--container"><h2 class="ds-related-content--heading">Related papers</h2><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="0" data-entity-id="18044919" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/18044919/Endoscopic_and_Percutaneous_Drainage_of_Symptomatic_Walled_Off_Pancreatic_Necrosis_Reduces_Hospital_Stay_and_Radiographic_Resources">Endoscopic and Percutaneous Drainage of Symptomatic Walled-Off Pancreatic Necrosis Reduces Hospital Stay and Radiographic Resources</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="38646405" href="https://independent.academia.edu/SIrani1">S. Irani</a><span>, </span><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="37983471" href="https://independent.academia.edu/OttoLin">Otto Lin</a><span>, </span><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="38141922" href="https://independent.academia.edu/GluckMichael">Michael Gluck</a><span>, </span><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="38200980" href="https://independent.academia.edu/RKozarek">Richard Kozarek</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Clinical Gastroenterology and Hepatology, 2010</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Endoscopic and Percutaneous Drainage of Symptomatic Walled-Off Pancreatic Necrosis Reduces Hospital Stay and Radiographic Resources","attachmentId":39845908,"attachmentType":"pdf","work_url":"https://www.academia.edu/18044919/Endoscopic_and_Percutaneous_Drainage_of_Symptomatic_Walled_Off_Pancreatic_Necrosis_Reduces_Hospital_Stay_and_Radiographic_Resources","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-related-work-grid-card-view-pdf" href="https://www.academia.edu/18044919/Endoscopic_and_Percutaneous_Drainage_of_Symptomatic_Walled_Off_Pancreatic_Necrosis_Reduces_Hospital_Stay_and_Radiographic_Resources"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="1" data-entity-id="87400182" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/87400182/Volume_but_Not_the_Location_of_Necrosis_Is_Associated_with_Worse_Outcomes_in_Acute_Pancreatitis_A_Prospective_Study">Volume, but Not the Location of Necrosis, Is Associated with Worse Outcomes in Acute Pancreatitis: A Prospective Study</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="32490643" href="https://lsmuni.academia.edu/ZilvinasDambrauskas">Zilvinas Dambrauskas</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Medicina</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Volume, but Not the Location of Necrosis, Is Associated with Worse Outcomes in Acute Pancreatitis: A Prospective 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