CT-guided percutaneous peripancreatic drainage: a possible therapy in acute necrotizing pancreatitis.
OBJECTIVE
To examine the effectiveness of therapeutic percutaneous drainage of peripancreatic fluid in the treatment of acute necrotizing pancreatitis.


METHODS
Twenty-eight patients treated for serious acute necrotizing pancreatitis (19 male, 9 female; average age 47.3 years) took part in the study. The cause of acute necrotizing pancreatitis was alcohol abuse in 20 of the cases, gallstone disease in 7 cases, endoscopic retrograde cholangiopancreatography in 2 cases, trauma in one case, and 4 of the cases had unknown cause. In all cases preventative antibiotics were given as part of intensive therapy, early nasojejunal nutrition was used, and we endeavored to avoid surgery or to delay it depending on the case. The acute peripancreatic fluid was drained percutaneously. In total, percutaneous drainage was used in 12 patients.


RESULTS
Of the 28 patients, only 3 patients recovered solely with conservative therapy, without drainage. Three patients recovered using only percutaneous drainage without surgery. In 9 patients surgery was necessary after percutaneous drainage was performed. In the remaining 13 patients, only surgical treatment was used, without percutaneous drainage. In total 20 reoperations were done in 10 patients. Of the 12 patients treated with percutaneous drainage, one patient died. The total mortality was 14.3%.


CONCLUSIONS
In certain cases the percutaneous drainage of the acute peripancreatic fluid that collects in acute necrotizing pancreatitis is sufficient for the total recovery of acute necrotizing pancreatitis, in other cases can be used to postpone surgery.
Szentkereszty
Zsolt
Z
2nd Department of Surgery, University of Debrecen Medical and Health Science Center, School of Medicine, Móricz Zs.krt. 22., Debrecen, 4004, Hungary.
Kerekes
László
L
Hallay
Judit
J
Czako
Danie
D
Sápy
Péter
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019283:Pancreatitis, Acute Necrotizing / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome