[Effectiveness of percutaneous drainage in the treatment of abdominal fluid collections in inflammatory pancreatic disease].
OBJECTIVE
To assess the effectiveness of ultrasonography-guided percutaneous drainage (UGPD) in the management of fluid collections (FC) in acute and chronic pancreatitis, and to evaluate factors associated with treatment results.


METHODS
Seventy-two patients with pancreatic fluid collections ranging from 5 to 20 cm (median 9 cm) were studied. There were 27 type I pseudocysts (PC), 12 type II PC, 13 type III PC, 16 abscesses, and 4 acute fluid collections. Catheters were placed in 60 patients and simple aspiration was performed in 8 patients. UGPD could not be performed in 4 patients.


RESULTS
UGPD was curative in 39 patients (54.1%): 44.4% in type I PC, 83% in type II PC, 30.7% in type III PC, 62.5% in abscesses, and 75% in acute FC. Resolution was achieved in 35.7% of patients with pancreatic duct communication and in 71.4% of those with non-communicated FC. No differences in effectiveness were observed according to the etiology of pancreatitis, pancreatic duct obstruction, drainage method, or the number or size of FC. UGPD was effective in 45.8% of the procedures performed before 1993, in 58.3% of those performed between 1993 and 1999, and in 63.6% of those performed after 2000. The complication rate was 37.5% and all complications were mild.


CONCLUSIONS
UGPD is an effective treatment for pancreatic FC. The effectiveness of this method depends on appropriate patient selection and careful management of acute pancreatitis. Outcomes were less favorable in patients with type III PC and in those with duct communication.
Macías Rodríguez
Manuel Alberto
MA
Servicio de Aparato Digestivo, Hospital Universitario Puerta del Mar, Cádiz, Spain. mmacias@comcadiz.com
Blanco Rodríguez
María José
MJ
Rendón Unceta
Paloma
P
Ramírez Navarro
Francisco
F
Abraldes Bechiarelli
Alfredo
A
Martín Herrera
Leopoldo
L
D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000000981:diagnostic imaging / Q000628:therapy*; D013396:Suction; D016896:Treatment Outcome; D014463:Ultrasonography