EARLY SURGICAL INTERVENTION IN ACUTE PANCREATITIS COMPLICATIONS: A PROSPECTIVE OBSERVATIONAL STUDY FROM A TERTIARY CARE CENTER IN NORTH INDIA
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Keywords
Acute pancreatitis; Early surgery; Pancreatic necrosis; Surgical timing; Morbidity; Tertiary care
Abstract
Background: Acute pancreatitis is a potentially severe inflammatory condition with significant morbidity and mortality, particularly in patients who develop complications such as pancreatic necrosis and organ failure. While current guidelines advocate delayed surgical intervention, the role of early surgery in selected complications remains controversial, especially in resource-limited settings.
Objectives: To evaluate the role of early surgical intervention in the management of complications of acute pancreatitis and to compare clinical outcomes with delayed or conservative management in a tertiary care hospital in North India.
Methods: This prospective observational study was conducted over five months (July–November 2020) and included 126 adult patients with complicated acute pancreatitis. Patients were categorized into early surgery (≤14 days) and delayed/conservative management groups. Data on demographics, etiology, complications, and outcomes were collected using a structured proforma. Statistical analysis was performed using SPSS version 22.0, with p<0.05 considered statistically significant.
Results: Of the 126 patients, 58 underwent early surgical intervention and 68 were managed conservatively or with delayed procedures. The baseline characteristics were comparable between groups. Early surgery was associated with a significantly higher rate of postoperative complications (37.9% vs 23.5%, p=0.048). Although mortality was higher in the early surgery group (17.2% vs 8.8%), the difference was not statistically significant. The duration of hospital stay was significantly shorter in the early surgery group (18.6 ± 6.2 days vs 22.4 ± 7.1 days, p=0.003). Patients operated within 7 days had the highest proportion of severe outcomes (p=0.041).
Conclusion: Early surgical intervention in acute pancreatitis complications is associated with increased morbidity and should be reserved for selected indications. Delayed intervention remains the preferred strategy in most cases. Individualized decision-making and improved access to minimally invasive approaches may enhance patient outcomes.
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr. Paresh Ranjan
Assistant Professor, Department of General Surgery, Varun Arjun Medical College, Shahjahanpur, Uttar Pradesh, India.
Dr. Vishal Anil Chawda
Assistant Professor, Department of General Surgery, V.R.K. Women's Medical College, Aziznagar, Hyderabad, Telangana, India.
Dr. Atul Kumar Soni
Professor, Department of General Surgery, Varun Arjun Medical College, Shahjahanpur, Uttar Pradesh, India.
