Outcomes of early ileocolectomy after percutaneous drainage for perforated ileocolic Crohn's disease.
BACKGROUND
The optimal treatment for an intra-abdominal abscess/infection secondary to perforating ileocolic Crohn's disease (PCD) is unclear.


METHODS
Forty-seven consecutive PCD patients treated via an institutional protocol of ileocolectomy after a 7-day period of percutaneous abscess drainage were retrospectively compared with 160 consecutive patients who underwent an elective ileocolectomy for Crohn's disease (ECD) between 1992 and 2014. Outcomes were compared using univariate analysis and propensity score matching.


RESULTS
Univariate analysis demonstrated significant differences in ileostomy rates (PCD: 48.9% vs ECD: 18.8%; P = .001), 30-day readmissions (PCD: 38.3% vs ECD: 18.8%; P = .01), and overall 30-day postoperative complications (PCD: 29.8% vs ECD: 15%; P = .03). After matching, a statistically significant difference was retained in ileostomy rates (P = .02) and 30-day readmissions (P = .01).


CONCLUSIONS
Early operative intervention after percutaneous drainage in perforating CD may be associated with a high incidence of diversions and readmissions.
Department of Surgery, The Pennsylvania State University, College of Medicine, 500 University Drive, Hershey, PA 17033-0850, USA.
William
W
Sangster
Department of Public Health Sciences, The Pennsylvania State University, College of Medicine, Hershey, PA, USA.
Arthur S
AS
Berg
Department of Surgery, The Pennsylvania State University, College of Medicine, 500 University Drive, Hershey, PA 17033-0850, USA.
Christine S
CS
Choi
Department of Surgery, The Pennsylvania State University, College of Medicine, 500 University Drive, Hershey, PA 17033-0850, USA.
Tara M
TM
Connelly
Department of Surgery, The Pennsylvania State University, College of Medicine, 500 University Drive, Hershey, PA 17033-0850, USA.
Charles H
CH
Chesnut
Department of Surgery, The Pennsylvania State University, College of Medicine, 500 University Drive, Hershey, PA 17033-0850, USA.
Walter A
WA
Koltun
Department of Surgery, The Pennsylvania State University, College of Medicine, 500 University Drive, Hershey, PA 17033-0850, USA. Electronic address: dstewart@hmc.psu.edu.
David B
DB
Stewart
D018784:Abdominal Abscess / Q000209:etiology / Q000601:surgery*; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015331:Cohort Studies; D003082:Colectomy; D003424:Crohn Disease / Q000150:complications / Q000628:therapy*; D004322:Drainage; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007081:Ileostomy / Q000706:statistics & numerical data; D007082:Ileum / Q000601:surgery*; D007416:Intestinal Perforation / Q000209:etiology / Q000601:surgery*; D008297:Male; D010289:Parenteral Nutrition, Total; D010359:Patient Readmission / Q000706:statistics & numerical data; D057216:Propensity Score; D012189:Retrospective Studies
D000900:Anti-Bacterial Agents; D005938:Glucocorticoids
Crohn's disease; General clinical; Surgery for IBD