title: Percutaneous catheter drainage for infective pancreatic necrosis: is it always the first choice for all patients?
abstract: OBJECTIVE
  To learn the clinical outcome of percutaneous catheter drainage (PCD) for patients with infective pancreatic necrosis and the possible influencing factors.
  
  
  METHODS
  A retrospective review of medical records of patients with infective pancreatic necrosis who received PCD as the first choice for treatment in the recent 2 years. The patients were divided into 2 groups: (1) PCD success group and (2) PCD alteration group. Characteristics, complications, and PCD process were compared.
  
  
  RESULTS
  In this study, 19 of 34 patients were cured by PCD alone (55.9%), whereas open necrosectomy were needed for 15 patients (44.1%). Between these 2 groups, most baseline and clinical characteristics did not show any statistical difference, including the number and size of catheter used and the bacterial culture result. The PCD alteration group had higher mean computed tomographic density (P = 0.012) and larger distribution range of infected pancreatic necrosis (4.53 ± 1.35 vs 5.93 ± 1.62; P = 0.009) than the PCD success group (P < 0.01). The logistic regression analysis revealed the same facts.
  
  
  CONCLUSIONS
  The mean computed tomographic density and distribution range of infective pancreatic necrosis could significantly influence the success rate of PCD; higher values of them indicate less appropriate for PCD; thus, it should be considered seriously before the treatment decision.
authors.affiliation: Department of Surgery, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China.
authors.forename: Zhihui
authors.initials: Z
authors.lastname: Tong
authors.forename: Weiqin
authors.initials: W
authors.lastname: Li
authors.forename: Wenkui
authors.initials: W
authors.lastname: Yu
authors.forename: Yanxia
authors.initials: Y
authors.lastname: Geng
authors.forename: Lu
authors.initials: L
authors.lastname: Ke
authors.forename: Yao
authors.initials: Y
authors.lastname: Nie
authors.forename: Jiakui
authors.initials: J
authors.lastname: Sun
authors.forename: Haibin
authors.initials: H
authors.lastname: Ni
authors.forename: Xinying
authors.initials: X
authors.lastname: Wang
authors.forename: Xianghong
authors.initials: X
authors.lastname: Ye
authors.forename: Ning
authors.initials: N
authors.lastname: Li
authors.forename: Jieshou
authors.initials: J
authors.lastname: Li
mesh_terms: D000328:Adult; D002404:Catheterization / Q000009:adverse effects / Q000295:instrumentation; D057785:Catheters; D002681:China; D004322:Drainage / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D019283:Pancreatitis, Acute Necrotizing / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery / Q000628:therapy*; D018579:Patient Selection; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome