Percutaneous Catheter Drainage in Infected Pancreatitis Necrosis: a Systematic Review

Ke, Lichi; Li, Junhua; Hu, Pei-Hong; Wang, Lianqun; Chen, Haiming; Zhu, Yushan

doi:10.1007/s12262-016-1495-9

Cited by 36 publications

(25 citation statements)

References 49 publications

(138 reference statements)

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“…One potential concern with percutaneous drainage is the high occurrence of external pancreatic fistula . In our study, nearly one‐third children developed pancreatic fistula.…”

Section: Discussionmentioning

confidence: 58%

Outcome of radiological interventions in pediatric gastrointestinal diseases: A large tertiary center experience

et al. 2018

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Background Interventional radiology (IR) is an indispensable component of multidisciplinary care in various gastrointestinal (GI) diseases. The literature on safety and utility of IR is limited in children. Objectives In this study, we aim to analyze the outcomes of IR in various pediatric GI diseases. Methods The data of children (≤18 years) who underwent radiological interventions for GI disorders (2009–2017) were analyzed, retrospectively. The indications for interventions included vascular (Budd Chiari syndrome [BCS], pseudoaneurysm) and nonvascular (pancreatic fluid collections [PFCs], cholangitis and anastomotic biliary strictures). The outcomes of radiological interventions, including success and adverse events, were assessed. Results A total of 93 children (mean age 13.45 ± 4.09 years) underwent radiological interventions for vascular (chronic BCS = 14, pseudoaneurysm = 28) or nonvascular (PFCs = 33, hepaticojejunostomy strictures or leaks = 12, cholangitis = 6) indications. Of 33 children who underwent drainage of PFCs, clinical success was noticed in 32 children during a mean follow‐up of 32.4 ± 21.66 months; 11 children with persistent external pancreatic fistula were managed with endoscopic pancreatic ductal stenting (8 children) and internalization of transgastric drain (3 children). In children who underwent hepatic vein or inferior vena cava stenting for BCS, mean stent patency was 78.57% during a follow‐up of 24.1 ± 13.78 months. In children with pseudoaneurysms, angioembolization was successfully performed in 92.8% patients. Re‐bleeding was noticed in two children, one of whom required reintervention. In children who underwent percutaneous transhepatic biliary drainage, resolution of anastomotic strictures was noticed in all during a follow‐up of 36.1 ± 13.73 months. Conclusion Interventional radiology is safe and effective in the management of various pediatric GI diseases.

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“…One potential concern with percutaneous drainage is the high occurrence of external pancreatic fistula . In our study, nearly one‐third children developed pancreatic fistula.…”

Section: Discussionmentioning

confidence: 58%

Outcome of radiological interventions in pediatric gastrointestinal diseases: A large tertiary center experience

et al. 2018

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“…PCD was considered as the first minimally invasive step in the treatment of clinically suspected or diagnosed infective necrotizing pancreatitis with resultant lesser complications. [6,7] Freeny et al evaluated 34 patients with acute necrotizing pancreatitis in whom the infected pancreatic necrosis was managed with percutaneous catheter drainage the disease resolved without surgery in 47% of the patients. As important, in 74% of patients sepsis was controlled, such that the PCD can be considered as a bridge to elective surgery.…”

Section: Discussionmentioning

confidence: 99%

“…This high rate has been primarily attributed by the presence of comorbid medical conditions and multisystem organ failure which is derived from a systemic response to pancreatitis. [6][7][8][9][10][11] Alternative nonsurgical techniques like percutaneous catheter drainage (PCD) have promising results of PCD in the treatment of the other complications which are routinely associated with AP, such as acute necrotising fluid collections. Limited studies have evaluated the role of CT-guided percutaneous catheter drainage in the care of patients with infected pancreatic necrosis.…”

Section: Introductionmentioning

confidence: 99%

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Role of Early Intervention in Improving the Clinical Outcome of Acute Pancreatitis by Image Guided Percutaneous Catheter Drainage of Pancreatic Collections

Sudha

Samireddypalle

Reddy

et al. 2020

AJMRR

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Background: To assess the role of image guided percutaneous drainage of acute pancreatic collections in influencing the clinical outcome of patients. Subjects and Methods: This is a prospective study done in the department of intervention radiology, Narayana medical college. About 20 cases have been performed in our institution from January 2019 to December 2019. All these drainage procedures have been done under CT guidance. All these cases were strictly followed during their hospital course. Clinical success has been defined as control of sepsis and prevention of MODS without the requirement of surgical debridement. Results: Out of twenty cases, which we intervened, there was an improvement in clinical outcome in fourteen cases with the prevention of septic shock and multiorgan failure. Three cases were critically ill at the time of admission and succumbed to MODS (Multiple organ dysfunction syndrome). The other three cases required additional surgical intervention-debridement. In which, there was increased morbidity with delayed recovery in two cases, and one case developed MODS and expired. Conclusion: Image guided Percutaneous catheter drainage is a safe and effective technique to drain pancreatic collections. Adequate knowledge regarding the interpretation of imaging findings, time to intervene, adequate expertise for performing the procedure, close follow up with regular clinical assessment is vital in the management of patients in acute pancreatitis. Early and aggressive intervention helps reduce the morbidity and mortality by preventing the evolution of MODS.

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“…Clinical success of PCD was defined as improvement without any further surgical intervention and was achieved in 56.2% (324) patients. 28 While 38.5% of patients needed additional intervention after initial PCD, overall mortality was 18% (104 patients). The major complications recorded were fistulae, organ failure and bleeding.…”

mentioning

confidence: 99%

Percutaneous Interventions in Acute Necrotizing Pancreatitis

Sharma¹

2016

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Acute pancreatitis (AP) is a disease of varying severity with acute necrotizing pancreatitis (ANP) being the severe form of AP. ANP needs multidisciplinary management and is associated with significant mortality and morbidity. Local complications of ANP viz. acute necrotic collections (ANC) and walled off pancreatic necrosis (WOPN) need intervention if they are associated with symptoms, sepsis or worsening organ failure. As surgery is associated with higher morbidity and mortality, there is paradigm shift in the management of these local complications with an increased emphasis on conservative and minimally invasive treatment approach. Image-guided percutaneous drainage (PCD) is a minimally invasive intervention that helps in drainage of infected collections, temporizes sepsis and improves outcomes in these patients. The present review discusses the utility of various percutaneous interventions in management of variety of pancreatic collections occurring in ANP. The available evidence, technical details and complications and emerging innovations in the field are also summarized. Acute Pancreatitis (AP) is an acute inflammatory disease of the pancreas, which is characterized by the frequent development of local or systemic complications. It is broadly divided into two morphological patterns: interstitial, which is merely associated with edema of the pancreatic parenchyma or necrotizing, in which peri-pancreatic and/or pancreatic necrosis is present. [1][2][3] In the early phase of acute pancreatitis the heightened inflammatory response dominates the clinical picture while the late phase is characterized by development of local infective as well as non-infective complications. The pancreatic inflammation results in exudation of pancreatic juice and subsequent injury to the peri-pancreatic fat and tissues. 2,3 This results in formation of collections which may be associated with both interstitial and necrotizing pancreatitis. While the collections formed in relation to interstitial pancreatitis are predominantly fluid and are called as acute fluid collections (AFC), KEYWORDS:

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Percutaneous Catheter Drainage in Infected Pancreatitis Necrosis: a Systematic Review

Cited by 36 publications

References 49 publications

Outcome of radiological interventions in pediatric gastrointestinal diseases: A large tertiary center experience

Outcome of radiological interventions in pediatric gastrointestinal diseases: A large tertiary center experience

Role of Early Intervention in Improving the Clinical Outcome of Acute Pancreatitis by Image Guided Percutaneous Catheter Drainage of Pancreatic Collections

Percutaneous Interventions in Acute Necrotizing Pancreatitis

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