Factors contributing to fatal outcome after treatment of pancreatic abscess.

The authors analyzed 27 patients with pancreatic abscess treated since 1975 at hospitals affiliated with the University of Louisville School of Medicine. Treatment consisted of careful debridement, abscess drainage, and multiple antibiotics in all patients. Overall mortality was 33%; however, only three of 17 patients treated since 1980 have died. Patients who died were more likely to have bacteremia, a residual abscess, multiple organ system failure, and/or polymicrobial growth on culture of the abscess. The proper use of soft suction drains in a dependent position reduced the rate of residual abscess to 19% compared to 67% in patients not treated in this fashion. The results identify factors that are correlates of death in patients with pancreatic abscess and emphasize the importance of prompt diagnosis and proper treatment.