Percutaneous CT-guided catheter drainage of infected acute necrotizing pancreatitis: techniques and results

AJR. American Journal of Roentgenology
P C FreenyM Sinanan

Abstract

The objective of this paper was to assess the safety and efficacy of percutaneous catheter drainage for initial treatment of infected acute necrotizing pancreatitis. Thirty-four patients with acute necrotizing pancreatitis shown with contrast-enhanced CT were treated for sepsis with percutaneous catheter drainage. Extent of necrosis was less than 30% in 10 cases, 30-50% in 10 cases, and greater than 50% in 14 cases. Fourteen patients had central necrosis. Eighteen patients were critically ill with multiorgan failure. Sixteen (47%) of the 34 patients were cured with only percutaneous catheter drainage, including four (29%) of the 14 patients with central gland necrosis and 12 (60%) of the 20 with body-tail necrosis. Sepsis was controlled (defervescence of fever and return of WBC to normal) in an additional nine patients, allowing elective pancreatic surgery for control of pancreatic duct fistula. Eight patients failed to show clinical improvement after drainage and required necrosectomy. No patient experienced catheter-related complications. Mortality was 12% (all four deaths occurred after necrosectomy because of multiorgan failure). Percutaneous catheter drainage is a safe and effective technique for treating infected acute ne...Continue Reading

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