Minimally Invasive Surgery for the Treatment of Moderate to Critical Acute Pancreatitis: A Case-matched Comparison With the Traditional Open Approach Over 10 years

Purpose: The purpose of this study is to compare short-term and midterm outcomes between patients with acute pancreatitis (AP) treated with minimally invasive surgery (MIS) and patients treated with open necrosectomy (ON).Materials and Methods: We compared data of all patients who had undergone MIS for AP with a similar group of patients with ON patients between January 2012 and June 2021 using a case-matched methodology based on AP severity and patient characteristics. Inhospital and midterm follow-up variables, including quality-oflife assessment, were evaluated.Results: Starting from a whole series of 79 patients with moderate to critical AP admitted to our referral center, the final study sample consisted of 24 patients (12 MIS and 12 ON). Post-operative (18.7 +/- 10.9 vs. 30.3 +/- 21.7 d; P = 0.05) and overall hospitalization (56.3 +/- 17.4 vs. 76.9 +/- 39.4 d; P = 0.05) were lower in the MIS group. Moreover, the Short-Form 36 scores in the ON group were statistically significantly lower in role limitations because of emotional problems (P = 0.002) and health changes (P = 0.03) at 3 and 6 months and because of emotional problems (P = 0.05), emotional well-being (P = 0.02), and general health (P = 0.007) at 1 year.Conclusions: MIS for the surgical management of moderate to critical AP seems to be a good option, as it could provide more chances for a better midterm quality of life compared with ON. Further studies are needed to confirm our findings.