Retrospective analysis of surgical pancreatic necrosectomy outcomes in patients with and without obesity

Background: Acute necrotizing pancreatitis is associated with high morbidity and mortality. This study aims to compare surgical necrosectomy outcomes in acute necrotizing pancreatitis between patients with and without obesity. Methods: A retrospective chart review was performed for all patients who underwent surgical necrosectomy via a minimally invasive approach or an open approach over a 10-year period at a large US healthcare system. Patients were divided into 2 groups: those with obesity (body mass index ≥30 kg/m²) and those without obesity (body mass index <30 kg/m²). The primary end point was the incidence of early complications or postoperative death within 30 and 90 days. The secondary end point was the incidence of long-term complications. Results: In total, 80 patients were included with 36 (45%) with obesity, and 44 (55%) without obesity. A total of 52 patients (65%) had an open approach and 28 (35%) had an minimally invasive approach. The average age was 54.79 ± 15.25 years, and the median follow-up time was 83.5 days (interquartile range, 40.25–149.75 days). The median body mass index of the patient group with obesity was 34.55 kg/m² (interquartile range, 31.55–40.61), and that for the patient group without obesity was 25.97 kg/m² (interquartile range, 23.22–28.35 kg/m²) (P ≤ .0001). Days from admission to surgical intervention was longer in obese patients but it was not statistically significant (44.50 [interquartile range, 12–88] vs 27 [interquartile range, 15–42.5], P = .831). 30 and 90-day complication rates and mortality were similar between the groups. Conclusion: Operative outcomes of pancreatic necrosectomy in patients with obesity appears to be comparable with patients without obesity. Surgical pancreatic necrosectomy can be performed safely, effectively, and in a similar time frame regardless of the presence of obesity.