Materials and Methods: A prospectively maintained database of all pancreatic cases requiring surgery was used to identify cases and the notes reviewed. Patients with infected pancreatic necrosis are managed in a step-up fashion according to a set protocol as described by Connor et al1. Results: 25 patients with a median age of 58 (22–79) and M : F = 13:12, underwent MARPN for infected necrosis in a four year period. The main aetiology was gallstones (68%) Each patient underwent debridement a median of 3 (1–7) times. 22 patients required ITU support with a median stay of 26 days (1–99) Median APACHE II score prior to ITU admission was 14 (8–27). Surgery related complications included bleeding (2), gastro-pancreatic
this website fistula,(1) enteric fistula (1) and colonic perforation (1). Pancreatitis related morbidity included pneumonia, renal failure, MODS and diabetes. 2 patients subsequently required laparotomy for complications. Overall in hospital mortality was 40% and median length of stay was 76 days.
Table 1: Mortality and APACHE II score by referral method Referred from other hospital? Died Alive % mortality Mean APACHE II score (p = 0.0715) Yes 8 8 50 18 No 2 Roscovitine 7 22 13 Discussion: Infected pancreatic necrosis can be managed using MARPN with an acceptable mortality rate provided patients are referred expediently. Though not statistically significant due to small numbers, it was apparent in our series that patients
transferred from other centres were sicker and had higher mortality (table 1), though exact reasons for this were not clear. Further education of non-specialists managing pancreatitis in other centres may improve outcomes for these patients. 1. Connor S, Ghaneh P, Raraty M, et al. Minimally invasive retroperitoneal pancreatic necrosectomy. Dig Surg. 2003;20:270–277. 2. Raraty M, Halloran C, Dodd S et al. Minimal Access Retroperitoneal Pancreatic Necrosectomy: 上海皓元医药股份有限公司 Improvement in Morbidity and Mortality With a Less Invasive Approach. Ann Surg 2010;251: 787–793 Y HUANG,1 G MACQUILLAN,1 L ADAMS,1,2 G GARAS,1 LJ MOU,1 A MITCHELL,1 L DELRIVIERE,1 GP JEFFREY1,2 1WA Liver Transplantation Service (WALTS), Sir Charles Gairdner Hospital, 2School of Medicine, University of Western Australia, Perth Introduction: The geographic isolation of Perth, WA has resulted in a significant number of recipients who received a donor liver transported from other states and New Zealand. The transport distances vary from 2132 km (1324 miles) to 5345 km (3321 miles). This allows a unique opportunity to evaluate the effect of long distance aircraft transport of donor livers on post-transplant (OLT) outcomes. Methods: 285 patients who had an OLT performed by the WALTS based at Sir Charles Gairdner Hospital, Perth from 1992 to 2012 were analysed. Donor and recipient clinical information was extracted from the WALTS database.