Clinical, diagnostic and therapeutic characterization of patients with pancreatic collections due to acute pancreatitis in a referral hospital

Abstract

Background – Pancreatic collections are a common complication of acute pancreatitis. In Latin America, information on the types of pancreatic collections and their management is limited and may vary between regions depending on the availability of highly specialised and minimally invasive treatment resources. Methods – Retrospective cohort of patients with acute pancreatic collections secondary to acute pancrea-titis treated at the Hospital Universitario San Ignacio, Bogotá (Colombia) between 2012–2023. Clinical characteristics, laboratory profiles and treatment received were described, comparing those who had a fatal outcome with those who did not. Results – Of 689 patients with acute pancreatitis, 113 presented with pancreatic collection (55.1% women, mean age 55 years). Of these, 47.8% presented with acute necrotic collection, 36.3% with acute fluid collection, 9.7% with walled-off necrosis and 6.2% with pancreatic pseudocyst. C-reactive protein, BUN, creatinine levels (at admission and at 48 hours), PaO2/FiO2 (at admission and at 48 hours) and antibiotic use were significantly associated with mortality (P<0.05). The majority of acute necrotic collections, walled-off necrosis and pseudo-cysts received interventional management, with minimally invasive and combined management being more common than surgical management. Antibiotic management was used in 48.6% of collections, although microbiological isolation was performed in only 24.7% of cases. Conclusion – Acute collections are a common and heterogeneous complication of pan-creatitis, requiring intervention more often in complicated collections. Certain laboratory parameters seem to be more associated with mortality.