{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T18:16:33Z","timestamp":1784916993092,"version":"3.55.0"},"reference-count":22,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2024,11,26]],"date-time":"2024-11-26T00:00:00Z","timestamp":1732579200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Victor Babes University of Medicine and Pharmacy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background and Objectives: Patients undergoing open necrosectomy (ON) for acute pancreatitis (AP) often face high morbidity and mortality rates. This study aims to identify risk factors associated with adverse outcomes by comparing survivors and non-survivors of ON. Materials and Methods: A retrospective analysis was conducted on 74 patients who underwent ON for AP. Patients were divided into two groups: survivors (n = 52) and non-survivors (n = 22). Preoperative and postoperative variables were compared, and p-values were calculated to identify significant differences. Results: The mortality rate was 29.73%. Significant risk factors for mortality included age over 60 (p = 0.008), multiple organ failure (p = 0.001), early necrosectomy before 28 days (p = 0.001), higher neutrophil-to-lymphocyte ratio (NLR) (p = 0.045), and postoperative complications such as bleeding (p = 0.005) and intestinal fistula (p = 0.038). Delayed ON after 28 days showed a significantly lower mortality rate (12.5%) compared to early ON (50%). Conclusions: Age, severity of AP, timing of ON, and postoperative complications significantly influence mortality rates in patients undergoing ON. Delaying surgery beyond 28 days and optimizing surgical techniques may improve patient outcomes.<\/jats:p>","DOI":"10.3390\/jcm13237151","type":"journal-article","created":{"date-parts":[[2024,11,26]],"date-time":"2024-11-26T05:06:53Z","timestamp":1732597613000},"page":"7151","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Risk Factors Influencing Mortality in Open Necrosectomy for Acute Pancreatitis: A Comparative Analysis"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5574-9340","authenticated-orcid":false,"given":"Tudorel","family":"Mihoc","sequence":"first","affiliation":[{"name":"Department X, Surgical Emergencies Clinic, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy Timi\u0219oara, Romania, 300041 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catalin","family":"Pirvu","sequence":"additional","affiliation":[{"name":"Department X, Surgical Emergencies Clinic, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy Timi\u0219oara, Romania, 300041 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5736-572X","authenticated-orcid":false,"given":"Amadeus","family":"Dobrescu","sequence":"additional","affiliation":[{"name":"Department X, 2nd Surgical Clinic, Researching Future \u201cChirurgie 2\u201d, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy Timi\u0219oara, Romania, 300041 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Brebu","sequence":"additional","affiliation":[{"name":"Department X, 2nd Surgical Clinic, Researching Future \u201cChirurgie 2\u201d, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy Timi\u0219oara, Romania, 300041 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anca Monica Oprescu","family":"Macovei","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Emergency Hospital Prof. Dr. Agripa Ionescu, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucuresti, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoran Laurentiu","family":"Popa","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy Timi\u0219oara, Romania, 300041 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6048-6909","authenticated-orcid":false,"given":"Stelian","family":"Pantea","sequence":"additional","affiliation":[{"name":"Department X, Surgical Emergencies Clinic, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy Timi\u0219oara, Romania, 300041 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1136\/gutjnl-2012-302779","article-title":"Classification of acute pancreatitis--2012: Revision of the Atlanta classification and definitions by international consensus","volume":"62","author":"Banks","year":"2013","journal-title":"Gut"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2379","DOI":"10.1111\/j.1572-0241.2006.00856.x","article-title":"Practice guidelines in acute pancreatitis","volume":"101","author":"Banks","year":"2006","journal-title":"Am. J. Gastroenterol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1016\/j.pan.2016.07.004","article-title":"Infection increases mortality in necrotizing pancreatitis: A systematic review and meta-analysis","volume":"16","author":"Werge","year":"2016","journal-title":"Pancreatology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1007\/BF01658069","article-title":"Necrosectomy and postoperative local lavage in patients with necrotizing pancreatitis: Results of a prospective clinical trial","volume":"12","author":"Beger","year":"1988","journal-title":"World J. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1254","DOI":"10.1053\/j.gastro.2011.06.073","article-title":"A conservative and minimally invasive approach to necrotizing pancreatitis improves outcome","volume":"141","author":"Bakker","year":"2011","journal-title":"Gastroenterology"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/s13017-019-0247-0","article-title":"2019 WSES guidelines for the management of severe acute pancreatitis","volume":"14","author":"Tolonen","year":"2019","journal-title":"World J. Emerg. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.1056\/NEJMoa0908821","article-title":"A step-up approach or open necrosectomy for necrotizing pancreatitis","volume":"362","author":"Besselink","year":"2010","journal-title":"N. Engl. J. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/s13017-020-00300-9","article-title":"Open necrosectomy in acute pancreatitis-obsolete or still useful?","volume":"15","author":"Husu","year":"2020","journal-title":"World J. Emerg. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1148\/radiology.174.2.2296641","article-title":"Acute pancreatitis: Value of CT in establishing prognosis","volume":"174","author":"Balthazar","year":"1990","journal-title":"Radiology"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1016\/j.amjsurg.2013.11.004","article-title":"A contemporary series of patients undergoing open debridement for necrotizing pancreatitis","volume":"208","author":"Madenci","year":"2014","journal-title":"Am. J. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1834","DOI":"10.1007\/s11605-018-04097-6","article-title":"High Rates of Readmission in Necrotizing Pancreatitis: Natural History or Opportunity for Improvement?","volume":"23","author":"Maatman","year":"2019","journal-title":"J. Gastrointest. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"S128","DOI":"10.1016\/j.surg.2012.05.021","article-title":"Minimally invasive operations for acute necrotizing pancreatitis: Comparison of minimally invasive retroperitoneal necrosectomy with endoscopic transgastric necrosectomy","volume":"152","author":"Bausch","year":"2012","journal-title":"Surgery"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1186\/s13017-020-00326-z","article-title":"Open necrosectomy is feasible as a last resort in selected cases with infected pancreatic necrosis: A case series and systematic literature review","volume":"15","author":"Sgaramella","year":"2020","journal-title":"World J. Emerg. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1016\/S0140-6736(00)02611-8","article-title":"Retroperitoneal endoscopic debridement for infected peripancreatic necrosis","volume":"356","author":"Seifert","year":"2000","journal-title":"Lancet"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1097\/00000658-200008000-00004","article-title":"Percutaneous necrosectomy and sinus tract endoscopy in the management of infected pancreatic necrosis: An initial experience","volume":"232","author":"Carter","year":"2000","journal-title":"Ann. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1007\/s004640080166","article-title":"A technique for laparoscopic-assisted percutaneous drainage of infected pancreatic necrosis and pancreatic abscess","volume":"15","author":"Horvath","year":"2001","journal-title":"Surg. Endosc."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1016\/j.dld.2011.04.001","article-title":"The \u2018step-up approach\u2019 to infected necrotizing pancreatitis: Delay, drain, debride","volume":"43","author":"Besselink","year":"2011","journal-title":"Dig. Liver Dis."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Besselink, M.G., van Santvoort, H.C., Nieuwenhuijs, V.B., Boermeester, M.A., Bollen, T.L., Buskens, E., Dejong, C.H., van Eijck, C.H., van Goor, H., and Hofker, S.S. (2006). Minimally invasive 'step-up approach' versus maximal necrosectomy in patients with acute necrotising pancreatitis (PANTER trial): Design and rationale of a randomised controlled multicenter trial [ISRCTN13975868]. BMC Surg., 6.","DOI":"10.1186\/1471-2482-6-6"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1016\/j.dld.2011.02.020","article-title":"Step-up approach to infected necrotising pancreatitis: A 20-year experience of percutaneous drainage in a single centre","volume":"43","author":"Zerem","year":"2011","journal-title":"Dig. Liver Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e28121","DOI":"10.1097\/MD.0000000000028121","article-title":"The BISAP score, NLR, CRP, or BUN: Which marker best predicts the outcome of acute pancreatitis?","volume":"100","author":"Dancu","year":"2021","journal-title":"Medicine"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Boicean, A., Prisca, D., Bratu, D.G., Bacila, C.I., Tanasescu, C., Chicea, R., Fleaca, S.R., Birsan, S.A., Ichim, C., and Mohor, C.I. (2024). Uncommon Presentation of Gastric Duplication Cyst with Left-Sided Portal Hypertension: A Case Report and Literature Review. Diagnostics, 14.","DOI":"10.3390\/diagnostics14070675"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Boicean, A., Ichim, C., Todor, S.B., Anderco, P., and Popa, M.L. (2024). The Importance of Microbiota and Fecal Microbiota Transplantation in Pancreatic Disorders. Diagnostics, 14.","DOI":"10.3390\/diagnostics14090861"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/23\/7151\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:39:30Z","timestamp":1760114370000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/23\/7151"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,26]]},"references-count":22,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["jcm13237151"],"URL":"https:\/\/doi.org\/10.3390\/jcm13237151","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,26]]}}}