CT-guided percutaneous catheter drainage of acute infectious necrotizing pancreatitis: assessment of effectiveness and safety.
OBJECTIVE
The purpose of this study is to assess retrospectively the effectiveness and safety of CT-guided percutaneous drainage and to determine the factors influencing clinical success and mortality in patients with infectious necrotizing pancreatitis.


METHODS
From April 1997 to December 2005, 48 consecutive patients (33 men and 15 women; median age, 58.5 years) with proven infectious necrotizing pancreatitis underwent percutaneous catheter drainage via CT guidance. Evaluated factors included clinical, biologic, and radiologic scores; drainage and catheter characteristics; and complications. Clinical success was defined as control of sepsis without requirement for surgery. Univariate analysis was performed to determine factors that could have affected the clinical success and the mortality rates.


RESULTS
Clinical success was achieved in 31 of 48 patients (64.6%) and was significantly associated with Ranson score (p = 0.01) and with the delay between admission and the beginning of the drainage (p = 0.005), with a calculated threshold delay of 18 days (p = 0.001). The global mortality rate (14/48 [29%]) was also influenced by the Ranson score (p = 01) and the delay of drainage (p = 0.04) with the same threshold delay (p = 0.01). Only two major nonlethal procedure-related complications were observed.


CONCLUSIONS
Percutaneous catheter drainage is a safe and effective technique to treat acute infectious necrotizing pancreatitis.
Department of Radiology, University Hospital of Nice, 151 Rte de Saint-Antoine de Ginestière, Nice, Alpes Maritimes 06200, France. baudin.g@chu-nice.fr
Guillaume
G
Baudin
Madleen
M
Chassang
Eve
E
Gelsi
Sébastien
S
Novellas
Gilles
G
Bernardin
Xavier
X
Hébuterne
Patrick
P
Chevallier
D044963:Biopsy, Fine-Needle; D002097:C-Reactive Protein / Q000032:analysis; D002404:Catheterization / Q000009:adverse effects; D004322:Drainage / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000473:pathology; D010185:Pancreatic Fistula / Q000209:etiology; D019283:Pancreatitis, Acute Necrotizing / Q000097:blood / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D011237:Predictive Value of Tests; D011856:Radiographic Image Enhancement; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
D002097:C-Reactive Protein