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Medical, Surgical Treatment of Pancreatic Necrosis Compared

Antibiotics, percutaneous drainage linked to greater long-term survival than surgery

THURSDAY, Jan. 6 (HealthDay News) -- Conservative primary treatment of infected pancreatic necrosis (IPN) with antibiotics and percutaneous drainage has a higher 10-year survival rate than does surgical necrosectomy, according to a study published in the December issue of Clinical Gastroenterology and Hepatology.

Pramod Kumar Garg, M.D., of the All India Institute of Medical Sciences in New Delhi, and colleagues compared outcomes from primary management of IPN with antibiotic therapy and percutaneous drainage against those obtained from necrosectomy. The team performed a retrospective study of 80 patients with IPN between 1997 and 2006. In addition, they gathered data on another 27 patients with IPN for a prospective study from 2007 to 2008.

The investigators found that the mortality rate for the medical and surgical groups were comparable. These results were confirmed in the prospective study. Between January 2003 and December 2008, 54.5 percent of patients were treated successfully with primary conservative therapy for IPN. Surgery was not required for 76 percent of these patients. The 10-year survival rate for the patients in the retrospective study was 76.9 percent in the medical group and 46.4 for those treated with surgery.

"Patients with infected necrosis treated medically had a better survival than those treated surgically," the authors conclude.

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