Xin-Bo Ai1, Xiao-Ping Qian1, Wen-Sheng Pan1, Jun Xu1, Liang-Qing Wu1, Wan-Jun Zhang1, An Wang1. 1. Department of Gastroenterology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China (Ai XB, Pan WS, Wu LQ, Zhang WJ) Department of Gastroenterology, Zhuhai People's Hospital, Third Affiliated Hospital of Jinan University School of Medicine, Zhuhai 519000, China (Ai XB, Wang A); Department of Radiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China (Qian XP); Department of Ultrasonography, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China (Xu J).
Abstract
BACKGROUND: Percutaneous catheter drainage (PCD) is a minimally invasive intervation for severe acute pancreatitis (SAP). This study was undertaken to compare the results of surgery and ultrasound-guided PCD in the treatment of 32 patients with SAP, and to direct clinicians to the most optimal approach for SAP. METHODS: In the 32 patients, 19 were proved to have deteriorated clinical signs or symptoms, extensive fluid exudation, and necrosis confirmed by computed tomography (CT) and they underwent operative debridement and drainage. For extensive fluid exudation or necrosis, complete liquefaction and safe catheter implantation, the other 13 patients were given PCD. RESULTS: The mortality rate of the surgery group was 26.3%, much higher than that of the PCD group (0%). There was a significant difference between the two groups (P=0.044). The mean time for recovery of the serum C-reactive protein (CRP) level was 43.8 days in the surgery group, which was significantly longer than that of the PCD group (23.8 days) (P=0.034). CONCLUSION: Early PCD guided by ultrasound could decrease the mortality of patients with severe acute pancreatitis, alleviate life-threatening inflammatory complications, and avoid unnecessary emergency operation.
BACKGROUND: Percutaneous catheter drainage (PCD) is a minimally invasive intervation for severe acute pancreatitis (SAP). This study was undertaken to compare the results of surgery and ultrasound-guided PCD in the treatment of 32 patients with SAP, and to direct clinicians to the most optimal approach for SAP. METHODS: In the 32 patients, 19 were proved to have deteriorated clinical signs or symptoms, extensive fluid exudation, and necrosis confirmed by computed tomography (CT) and they underwent operative debridement and drainage. For extensive fluid exudation or necrosis, complete liquefaction and safe catheter implantation, the other 13 patients were given PCD. RESULTS: The mortality rate of the surgery group was 26.3%, much higher than that of the PCD group (0%). There was a significant difference between the two groups (P=0.044). The mean time for recovery of the serum C-reactive protein (CRP) level was 43.8 days in the surgery group, which was significantly longer than that of the PCD group (23.8 days) (P=0.034). CONCLUSION: Early PCD guided by ultrasound could decrease the mortality of patients with severe acute pancreatitis, alleviate life-threatening inflammatory complications, and avoid unnecessary emergency operation.
Entities:
Keywords:
Clinical efficacy; Operation; Percutaneous catheter drainage; Severe acute pancreatitis
Authors: Koenraad J Mortelé; Jeffrey Girshman; Denis Szejnfeld; Stanley W Ashley; Sukru M Erturk; Peter A Banks; Stuart G Silverman Journal: AJR Am J Roentgenol Date: 2009-01 Impact factor: 3.959