title: [The clinical effectiveness of percutaneous drainage and laparotomy for patients with infective pancreatic necrosis].
abstract: OBJECTIVE
  To compare the clinical effectiveness of percutaneous US- or CT-guided drainage and laparotomy for patients with infective pancreatic necrosis.
  
  
  METHODS
  Data of 90 infective pancreatic necrosis patients admitted from January 2008 to December 2009 were included. They were divided into two groups by the different treatment choices. Twenty-seven patients in the percutaneous group received percutaneous US- or CT-guided drainage as first choice. After that a sump suction apparatus was applied for controlled drainage. If no improvement was achieved after 3 days, they would received operation soon. While patients in the laparotomy group received surgical drainage at the time when the diagnosis of infected pancreatic necrosis was confirmed. Continuous drainage was also applied for these ones.
  
  
  RESULTS
  The percutaneous group had a significant low rate of reoperation (7.1% vs. 14.3%, P < 0.05) and postoperative residual abscesses (7.1% vs. 28.6%, P < 0.05). Furthermore, 48.1% of patients in percutaneous group successfully avoid laparotomy. In the regard of complications, the percutaneous group presented lower incidence of both single organ dysfunction (7.4% vs. 28.6%, P < 0.05), intestinal fistula (7.4% vs. 27.0%, P < 0.05) and long-term complications (3.7% vs. 22.2%, P < 0.05). In addition, the percutaneous group costed less medical resources as evidenced by shorter ICU duration (21.2 ± 9.7 vs. 28.7 ± 12.1, P < 0.01), shorter hospital duration (48.2 ± 12.5 vs. 59.6 ± 17.5, P < 0.05) and less expenditure (191 762 ± 5892 vs. 341 689 ± 10 854, P < 0.05).
  
  
  CONCLUSIONS
  Percutaneous drainage can effectively lower the surgical rates and the rates of complications and reoperations in patients with infective pancreatic necrosis. Besides that, it could also reduce the cost of medical resources.
authors.affiliation: Research Institute of General Surgery, Jinling Hospital, Medicine School of Nanjing University, China.
authors.forename: Zhi-hui
authors.initials: ZH
authors.lastname: Tong
authors.forename: Wei-qin
authors.initials: WQ
authors.lastname: Li
authors.forename: Wen-kui
authors.initials: WK
authors.lastname: Yu
authors.forename: Xin-ying
authors.initials: XY
authors.lastname: Wang
authors.forename: Xiang-hong
authors.initials: XH
authors.lastname: Ye
authors.forename: Yao
authors.initials: Y
authors.lastname: Nie
authors.forename: Lu
authors.initials: L
authors.lastname: Ke
authors.forename: Xiao-fan
authors.initials: XF
authors.lastname: Xu
authors.forename: Jun
authors.initials: J
authors.lastname: Lu
authors.forename: Hai-bin
authors.initials: HB
authors.lastname: Ni
authors.forename: Jia-kui
authors.initials: JK
authors.lastname: Sun
authors.forename: Ning
authors.initials: N
authors.lastname: Li
authors.forename: Jie-shou
authors.initials: JS
authors.lastname: Li
mesh_terms: D000328:Adult; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D019283:Pancreatitis, Acute Necrotizing / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome