Pancreatic Abscesses; To Determine the Surgical Outcome, Effectiveness and the Complications of Computer Tomography Guided Drainage

Abstract

The objective of our study is to determine the surgical outcome, effectiveness and the complications of computer tomography guided drainage of pancreatic abscesses. Study Design: Descriptive case series. Setting: Tertiary care hospital in Karachi Pakistan. Period: Three years from November 2012 to October 2015. Methods: The patient population consisted of all those patients who were diagnosed as a case of pancreatic abscess both clinically and on radiographic analysis, and who had to have the computer tomography guided percutaneous drainage of the abscess. The drained fluid was sent for histopathologic and cytological analysis, and a drain was placed in the pancreatic tissue for further collection of the discharge material. Patients were followed for up to 40 days post operatively, and various complications were noted. Results: The patient population consisted of n=550 patients of acute pancreatitis, out of which n=30 (5.45%) were diagnosed cases of pancreatic abscess, out of these patients n=5 (16.67%) were males and n=25 (83.33%) were females, and the mean age of patients was 44 +/-11 years. In n=24 (80%) of patients the abscess resolved completely in 20 to 40 days. N=5 (20%) of patients had complications and had to undergo laparotomy. Conclusion: According to the results of our study, the computer tomographic guided drainage of the pancreatic abscess is a very safe and effective procedure for the treatment of pancreatic abscess. The rate of complications is low, and patients show swift recovery post operatively.

Pancreatic abscess: a modern look at an old problem

“…Once the abscess is diagnosed, immediate combined antibacterial and, if possible, minimally invasive drainage should be performed. In recent years there are many results of successful surgical treatment of abdominal abscesses of various localizations, including the pancreas, by drainage under ultrasound or CT guidance (Jo, 2015;Lee, 2017;Rani, 2016;Yang, 2016). Shavrina et al (2019) 2019) didn't find significant difference in mortality (endoscopy 8.8% vs surgery 6.3%; P = .999), but complications rate was significantly higher in the surgery group (0.69 ± 1.03) compared with the endoscopy group (0.15 ± 0.44) (P = .007).…”

“…Pancreatic abscesses (PA) are attributed to nonspecific surgical abdominal infections, the main cause is purulent-destructive and degenerative diseases of the pancreas. PA is a polyethiological condition to the formation of which lead chronic (Ammann,1992;Gedam, 2017;Rodríguez, 2020) and acute pancreatitis (Fink, 1988;Rani, 2016;Reuken, 2018), the annual incidence of which ranges from 13 to 45 per 100,000 persons. (Hoilat & Katta, 2021).…”