Long-term follow-up study of necrotising pancreatitis: Interventions, complications and quality of life

Robbert A. Hollemans; Hester C. Timmerhuis; Marc G. Besselink; Stefan A.W. Bouwense; Marco Bruno; Peter Van Duijvendijk; Erwin Jan Van Geenen; Muhammed Hadithi; Sybrand Hofker; Jeanin E. Van-Hooft; Liesbeth M. Kager; Eric R. Manusama; Jan Werner Poley; Rutger Quispel; Tessa Römkens; George P. Van Der Schelling; Matthijs P. Schwartz; Bernhard W.M. Spanier; Martijn Stommel; Adriaan Tan; Niels G. Venneman; Frank Vleggaar; Roy L.J. Van Wanrooij; Thomas L. Bollen; Rogier P. Voermans; Robert C. Verdonk; Hjalmar C. Van Santvoort

doi:10.1136/gutjnl-2023-329735

Long-term follow-up study of necrotising pancreatitis: Interventions, complications and quality of life

Robbert A. Hollemans
, Hester C. Timmerhuis^*
, Marc G. Besselink
, Stefan A.W. Bouwense
, Marco Bruno
, Peter Van Duijvendijk
, Erwin Jan Van Geenen
, Muhammed Hadithi
, Sybrand Hofker
, Jeanin E. Van-Hooft
, Liesbeth M. Kager
, Eric R. Manusama
, Jan Werner Poley
, Rutger Quispel
, Tessa Römkens
, George P. Van Der Schelling
, Matthijs P. Schwartz
, Bernhard W.M. Spanier
, Martijn Stommel
, Adriaan Tan

Niels G. Venneman, Frank Vleggaar, Roy L.J. Van Wanrooij, Thomas L. Bollen, Rogier P. Voermans, Robert C. Verdonk, Hjalmar C. Van Santvoort

^*Corresponding author for this work

Gastroenterology & Hepatology

St. Antonius Ziekenhuis
University of Amsterdam
Amsterdam UMC
Maastricht University
Gelre Ziekenhuizen
Radboud University Medical Center
University Medical Centre Groningen
Leiden University
North West Hospital Group
Medical Centre Leeuwarden
Jeroen Bosch Ziekenhuis
Amphia Hospital
Meander Medical Center
Rijnstate Hospital
Canisius Wilhelmina Hospital
Medisch Spectrum Twente
Utrecht University
VU University Medical Center
Reinier de Graaf Hospital

Research output: Contribution to journal › Article › Academic › peer-review

19 Citations (Scopus)

32 Downloads (Pure)

Abstract

Objective:

To describe the long-term consequences of necrotising pancreatitis, including complications, the need for interventions and the quality of life.

Design:

Long-term follow-up of a prospective multicentre cohort of 373 necrotising pancreatitis patients (2005-2008) was performed. Patients were prospectively evaluated and received questionnaires. Readmissions (ie, for recurrent or chronic pancreatitis), interventions, pancreatic insufficiency and quality of life were compared between initial treatment groups: conservative, endoscopic/percutaneous drainage alone and necrosectomy. Associations of patient and disease characteristics during index admission with outcomes during follow-up were assessed.

Results:

During a median follow-up of 13.5 years (range 12-15.5 years), 97/373 patients (26%) were readmitted for recurrent pancreatitis. Endoscopic or percutaneous drainage was performed in 47/373 patients (13%), of whom 21/47 patients (45%) were initially treated conservatively. Pancreatic necrosectomy or pancreatic surgery was performed in 31/373 patients (8%), without differences between treatment groups. Endocrine insufficiency (126/373 patients; 34%) and exocrine insufficiency (90/373 patients; 38%), developed less often following conservative treatment (p<0.001 and p=0.016, respectively). Quality of life scores did not differ between groups. Pancreatic gland necrosis >50% during initial admission was associated with percutaneous/endoscopic drainage (OR 4.3 (95% CI 1.5 to 12.2)), pancreatic surgery (OR 3.2 (95% CI 1.1 to 9.5) and development of endocrine insufficiency (OR13.1 (95% CI 5.3 to 32.0) and exocrine insufficiency (OR6.1 (95% CI 2.4 to 15.5) during follow-up.

Conclusion:

Acute necrotising pancreatitis carries a substantial disease burden during long-term follow-up in terms of recurrent disease, the necessity for interventions and development of pancreatic insufficiency, even when treated conservatively during the index admission. Extensive (>50%) pancreatic parenchymal necrosis seems to be an important predictor of interventions and complications during follow-up.

Original language	English
Article number	gutjnl-2023-329735
Pages (from-to)	787-796
Number of pages	10
Journal	Gut
Volume	73
Issue number	5
Early online date	24 Jan 2024
DOIs	https://doi.org/10.1136/gutjnl-2023-329735
Publication status	Published - 24 Jan 2024

Bibliographical note

Publisher Copyright:
© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.

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10.1136/gutjnl-2023-329735

Long-term follow-up study of necrotising pancreatitis interventions, complications and quality of lifeFinal published version, 914 KBLicence: Article 25fa Dutch Copyright Act

Cite this

Hollemans, R. A., Timmerhuis, H. C., Besselink, M. G., Bouwense, S. A. W., Bruno, M., Van Duijvendijk, P., Van Geenen, E. J., Hadithi, M., Hofker, S., Van-Hooft, J. E., Kager, L. M., Manusama, E. R., Poley, J. W., Quispel, R., Römkens, T., Van Der Schelling, G. P., Schwartz, M. P., Spanier, B. W. M., Stommel, M., ... Van Santvoort, H. C. (2024). Long-term follow-up study of necrotising pancreatitis: Interventions, complications and quality of life. Gut, 73(5), 787-796. Article gutjnl-2023-329735. https://doi.org/10.1136/gutjnl-2023-329735

@article{8fd22e28567b4a3983d761471081e7f0,

title = "Long-term follow-up study of necrotising pancreatitis: Interventions, complications and quality of life",

abstract = "Objective: To describe the long-term consequences of necrotising pancreatitis, including complications, the need for interventions and the quality of life. Design: Long-term follow-up of a prospective multicentre cohort of 373 necrotising pancreatitis patients (2005-2008) was performed. Patients were prospectively evaluated and received questionnaires. Readmissions (ie, for recurrent or chronic pancreatitis), interventions, pancreatic insufficiency and quality of life were compared between initial treatment groups: conservative, endoscopic/percutaneous drainage alone and necrosectomy. Associations of patient and disease characteristics during index admission with outcomes during follow-up were assessed. Results: During a median follow-up of 13.5 years (range 12-15.5 years), 97/373 patients (26\%) were readmitted for recurrent pancreatitis. Endoscopic or percutaneous drainage was performed in 47/373 patients (13\%), of whom 21/47 patients (45\%) were initially treated conservatively. Pancreatic necrosectomy or pancreatic surgery was performed in 31/373 patients (8\%), without differences between treatment groups. Endocrine insufficiency (126/373 patients; 34\%) and exocrine insufficiency (90/373 patients; 38\%), developed less often following conservative treatment (p<0.001 and p=0.016, respectively). Quality of life scores did not differ between groups. Pancreatic gland necrosis >50\% during initial admission was associated with percutaneous/endoscopic drainage (OR 4.3 (95\% CI 1.5 to 12.2)), pancreatic surgery (OR 3.2 (95\% CI 1.1 to 9.5) and development of endocrine insufficiency (OR13.1 (95\% CI 5.3 to 32.0) and exocrine insufficiency (OR6.1 (95\% CI 2.4 to 15.5) during follow-up.Conclusion: Acute necrotising pancreatitis carries a substantial disease burden during long-term follow-up in terms of recurrent disease, the necessity for interventions and development of pancreatic insufficiency, even when treated conservatively during the index admission. Extensive (>50\%) pancreatic parenchymal necrosis seems to be an important predictor of interventions and complications during follow-up.",

author = "Hollemans, \{Robbert A.\} and Timmerhuis, \{Hester C.\} and Besselink, \{Marc G.\} and Bouwense, \{Stefan A.W.\} and Marco Bruno and \{Van Duijvendijk\}, Peter and \{Van Geenen\}, \{Erwin Jan\} and Muhammed Hadithi and Sybrand Hofker and Van-Hooft, \{Jeanin E.\} and Kager, \{Liesbeth M.\} and Manusama, \{Eric R.\} and Poley, \{Jan Werner\} and Rutger Quispel and Tessa R{\"o}mkens and \{Van Der Schelling\}, \{George P.\} and Schwartz, \{Matthijs P.\} and Spanier, \{Bernhard W.M.\} and Martijn Stommel and Adriaan Tan and Venneman, \{Niels G.\} and Frank Vleggaar and \{Van Wanrooij\}, \{Roy L.J.\} and Bollen, \{Thomas L.\} and Voermans, \{Rogier P.\} and Verdonk, \{Robert C.\} and \{Van Santvoort\}, \{Hjalmar C.\}",

note = "Publisher Copyright: {\textcopyright} Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.",

year = "2024",

month = jan,

day = "24",

doi = "10.1136/gutjnl-2023-329735",

language = "English",

volume = "73",

pages = "787--796",

journal = "Gut",

issn = "0017-5749",

publisher = "BMJ Publishing Group",

number = "5",

}

Hollemans, RA, Timmerhuis, HC, Besselink, MG, Bouwense, SAW, Bruno, M, Van Duijvendijk, P, Van Geenen, EJ, Hadithi, M, Hofker, S, Van-Hooft, JE, Kager, LM, Manusama, ER, Poley, JW, Quispel, R, Römkens, T, Van Der Schelling, GP, Schwartz, MP, Spanier, BWM, Stommel, M, Tan, A, Venneman, NG, Vleggaar, F, Van Wanrooij, RLJ, Bollen, TL, Voermans, RP, Verdonk, RC & Van Santvoort, HC 2024, 'Long-term follow-up study of necrotising pancreatitis: Interventions, complications and quality of life', Gut, vol. 73, no. 5, gutjnl-2023-329735, pp. 787-796. https://doi.org/10.1136/gutjnl-2023-329735

TY - JOUR

T1 - Long-term follow-up study of necrotising pancreatitis

T2 - Interventions, complications and quality of life

AU - Hollemans, Robbert A.

AU - Timmerhuis, Hester C.

AU - Besselink, Marc G.

AU - Bouwense, Stefan A.W.

AU - Bruno, Marco

AU - Van Duijvendijk, Peter

AU - Van Geenen, Erwin Jan

AU - Hadithi, Muhammed

AU - Hofker, Sybrand

AU - Van-Hooft, Jeanin E.

AU - Kager, Liesbeth M.

AU - Manusama, Eric R.

AU - Poley, Jan Werner

AU - Quispel, Rutger

AU - Römkens, Tessa

AU - Van Der Schelling, George P.

AU - Schwartz, Matthijs P.

AU - Spanier, Bernhard W.M.

AU - Stommel, Martijn

AU - Tan, Adriaan

AU - Venneman, Niels G.

AU - Vleggaar, Frank

AU - Van Wanrooij, Roy L.J.

AU - Bollen, Thomas L.

AU - Voermans, Rogier P.

AU - Verdonk, Robert C.

AU - Van Santvoort, Hjalmar C.

PY - 2024/1/24

Y1 - 2024/1/24

N2 - Objective: To describe the long-term consequences of necrotising pancreatitis, including complications, the need for interventions and the quality of life. Design: Long-term follow-up of a prospective multicentre cohort of 373 necrotising pancreatitis patients (2005-2008) was performed. Patients were prospectively evaluated and received questionnaires. Readmissions (ie, for recurrent or chronic pancreatitis), interventions, pancreatic insufficiency and quality of life were compared between initial treatment groups: conservative, endoscopic/percutaneous drainage alone and necrosectomy. Associations of patient and disease characteristics during index admission with outcomes during follow-up were assessed. Results: During a median follow-up of 13.5 years (range 12-15.5 years), 97/373 patients (26%) were readmitted for recurrent pancreatitis. Endoscopic or percutaneous drainage was performed in 47/373 patients (13%), of whom 21/47 patients (45%) were initially treated conservatively. Pancreatic necrosectomy or pancreatic surgery was performed in 31/373 patients (8%), without differences between treatment groups. Endocrine insufficiency (126/373 patients; 34%) and exocrine insufficiency (90/373 patients; 38%), developed less often following conservative treatment (p<0.001 and p=0.016, respectively). Quality of life scores did not differ between groups. Pancreatic gland necrosis >50% during initial admission was associated with percutaneous/endoscopic drainage (OR 4.3 (95% CI 1.5 to 12.2)), pancreatic surgery (OR 3.2 (95% CI 1.1 to 9.5) and development of endocrine insufficiency (OR13.1 (95% CI 5.3 to 32.0) and exocrine insufficiency (OR6.1 (95% CI 2.4 to 15.5) during follow-up.Conclusion: Acute necrotising pancreatitis carries a substantial disease burden during long-term follow-up in terms of recurrent disease, the necessity for interventions and development of pancreatic insufficiency, even when treated conservatively during the index admission. Extensive (>50%) pancreatic parenchymal necrosis seems to be an important predictor of interventions and complications during follow-up.

AB - Objective: To describe the long-term consequences of necrotising pancreatitis, including complications, the need for interventions and the quality of life. Design: Long-term follow-up of a prospective multicentre cohort of 373 necrotising pancreatitis patients (2005-2008) was performed. Patients were prospectively evaluated and received questionnaires. Readmissions (ie, for recurrent or chronic pancreatitis), interventions, pancreatic insufficiency and quality of life were compared between initial treatment groups: conservative, endoscopic/percutaneous drainage alone and necrosectomy. Associations of patient and disease characteristics during index admission with outcomes during follow-up were assessed. Results: During a median follow-up of 13.5 years (range 12-15.5 years), 97/373 patients (26%) were readmitted for recurrent pancreatitis. Endoscopic or percutaneous drainage was performed in 47/373 patients (13%), of whom 21/47 patients (45%) were initially treated conservatively. Pancreatic necrosectomy or pancreatic surgery was performed in 31/373 patients (8%), without differences between treatment groups. Endocrine insufficiency (126/373 patients; 34%) and exocrine insufficiency (90/373 patients; 38%), developed less often following conservative treatment (p<0.001 and p=0.016, respectively). Quality of life scores did not differ between groups. Pancreatic gland necrosis >50% during initial admission was associated with percutaneous/endoscopic drainage (OR 4.3 (95% CI 1.5 to 12.2)), pancreatic surgery (OR 3.2 (95% CI 1.1 to 9.5) and development of endocrine insufficiency (OR13.1 (95% CI 5.3 to 32.0) and exocrine insufficiency (OR6.1 (95% CI 2.4 to 15.5) during follow-up.Conclusion: Acute necrotising pancreatitis carries a substantial disease burden during long-term follow-up in terms of recurrent disease, the necessity for interventions and development of pancreatic insufficiency, even when treated conservatively during the index admission. Extensive (>50%) pancreatic parenchymal necrosis seems to be an important predictor of interventions and complications during follow-up.

UR - https://www.scopus.com/pages/publications/85183875880

U2 - 10.1136/gutjnl-2023-329735

DO - 10.1136/gutjnl-2023-329735

M3 - Article

C2 - 38267201

AN - SCOPUS:85183875880

SN - 0017-5749

VL - 73

SP - 787

EP - 796

JO - Gut

JF - Gut

IS - 5

M1 - gutjnl-2023-329735

ER -

Long-term follow-up study of necrotising pancreatitis: Interventions, complications and quality of life

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