Percutaneous Drainage for Treatment of Infected Pancreatic Pseudocysts

Cantasdemir, Murat; Kara, Batuhan; Kantarcı, Fatih; Mihmanlı, İsmail; Numan, Fürüzan; Ergüney, Sabri

doi:10.1097/01.smj.0000050682.65270.38

Cited by 29 publications

(25 citation statements)

References 14 publications

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“…Antimicrobial therapy should be tailored to FNA culture speciation and sensitivities; however, empiric treatment with antibiotics active against the most common pathogens in infected pancreatic necrosis (E. coli, Bacteroides species, Enterobacter species, Klebsiella species and S. faecalis as well as other grampositive organisms such as S. epidermidis and S. aureus 103,104 ) may be considered until final culture results are available.…”

Section: Diagnosis and Management Of Local Complications Of Acute Panmentioning

confidence: 99%

“…The most common bacteria cultured in an infected pseudocyst are enteric microorganisms, such as E. coli, Bacteroides species, Enterobacter species, Klebsiella species and S. faecalis as well as other grampositive organisms, such as S. epidermidis and S. aureus. 103,104 General indications for intervention are symptomatic pseudocysts, complications or infection of a pseudocyst, or increasing size on serial imaging. [125][126][127][128] Many options are available for the management of pancreatic pseudocysts, including percutaneous, endoscopic or surgical drainage (open and laparoscopic) and creation of a cystogastrostomy (endoscopically or surgicallly).…”

Section: -119mentioning

confidence: 99%

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Clinical practice guideline: management of acute pancreatitis

Greenberg¹,

Hsu²,

Bawazeer³

et al. 2016

cjs

310

352

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There has been an increase in the incidence of acute pancreatitis reported worldwide. Despite improvements in access to care, imaging and interventional techniques, acute pancreatitis continues to be associated with significant morbidity and mortality. Despite the availability of clinical practice guidelines for the management of acute pancreatitis, recent studies auditing the clinical management of the condition have shown important areas of noncompliance with evidence-based recommendations. This underscores the importance of creating understandable and implementable recommendations for the diagnosis and management of acute pancreatitis. The purpose of the present guideline is to provide evidence-based recommendations for the management of both mild and severe acute pancreatitis as well as the management of complications of acute pancreatitis and of gall stone-induced pancreatitis.Une hausse de l'incidence de pancréatite aiguë a été constatée à l'échelle mondiale. Malgré l'amélioration de l'accès aux soins et aux techniques d'imagerie et d'intervention, la pancréatite aiguë est toujours associée à une morbidité et une mortalité importantes. Bien qu'il existe des guides de pratique clinique pour la prise en charge de la pancréatite aiguë, des études récentes sur la vérification de la prise en charge clinique de cette affection révèlent des lacunes importantes dans la conformité aux recommandations fondées sur des données probantes. Ces résultats mettent en relief l'importance de formuler des recommandations compréhensibles et applicables pour le diagnostic et la prise en charge de la pancréatite aiguë. La présente ligne directrice vise à fournir des recommandations fondées sur des données probantes pour la prise en charge de la pancréatite aiguë, qu'elle soit bénigne ou grave, ainsi que de ses complications et de celles de la pancréatite causée par un calcul biliaire.A cute pancreatitis can range from a mild, self-limiting disease that requires no more than supportive measures to severe disease with lifethreatening complications. The most common causes of acute pan creatitis are gallstones and binge alcohol consumption.1 There has been an increase in the incidence of acute pancreatitis reported worldwide. Despite improvements in access to care, imaging and interventional techniques, acute pancreatitis continues to be associated with significant morbidity and mortality.A systematic review of clinical practice guidelines for the management of acute pancreatitis revealed 14 guidelines published between 2004 and 2008 alone.2 Although these guidelines have significant overlap in their recommendations for diagnosing and managing acute pancreatitis, there is disagreement in some aspects of both the timing and types of interventions that should be used for both mild and severe acute pancreatitis. The availability of new imaging modalities and noninvasive therapies has also changed clinical practice. Finally, despite the availability of guidelines, recent studies auditing clinical management of acute pancreatitis have sh...

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Section: Diagnosis and Management Of Local Complications Of Acute Panmentioning

confidence: 99%

Section: -119mentioning

confidence: 99%

Clinical practice guideline: management of acute pancreatitis

Greenberg¹,

Hsu²,

Bawazeer³

et al. 2016

cjs

310

352

View full text Add to dashboard Cite

show abstract

“…Contrary to several other studies [7,10] ultrasound was used for diagnosis and guidance for drainage in our case. We believe that in the majority of cases, ultrasound can clearly provide the optimal depiction of abscesses, the potential insertion route for drainage, and the optimal position of catheters without risk of exposition to irradiation.…”

Section: Discussionmentioning

confidence: 75%

“…It is more common in postoperative pancreatitis (40%) than in alcoholic (4%) or biliary (7%) causes. The abscess develops due to superinfection of necrotic pancreatic and retroperitoneal tissues due to superinfection of acute fluid collections [9,10]. Several reports have shown that open surgery and immediate surgical necrosectomy for pancreatic necrosis could result in a poor clinical outcome, frequently associated with reoperations and development of complications such as infected pancreatic collections and fistulas [3,4,5].…”

Section: Discussionmentioning

confidence: 99%

Successful Percutaneous Drainage with Iodine Irrigation for Pancreatic Fistulas and Abscesses after Necrotizing Pancreatitis

Zerem

Omerović

2012

Med Princ Pract

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Objective: To report an uncommon method of managing pancreatic fistulas and retroperitoneal abscess. Clinical Presentation and Intervention: A 50-year-old man was admitted with fever, abdominal pain, periumbilical fistula and pus in stool. Five months before admission, he underwent urgent necrosectomy (7 days after onset of pain) and subsequently two more surgeries for necrotizing pancreatitis. Ultrasound revealed fluid collection in the retropancreatic space. After evacuation of pus, contrast medium instilled through a catheter showed a retroperitoneal abscess cavity, retroperitoneal-periumbilical and retroperitoneal-sigmoidal fistulas. After percutaneous drainage and iodine irrigation, the abscess collection and fistulas disappeared. Conclusion: In this case, percutaneous drainage was a successful option in the management of pancreatic fistulas and a retroperitoneal abscess.

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“…It is worth stressing that in selected patients, percutaneous drainage is only one of the stages of treatment (2,(16)(17)(18)(19)(20)(21). During the past years constant progress in the diagnostic and procedural techniques has been observed.…”

Section: Discussionmentioning

confidence: 99%

Drainage of Pancreatic Abscesses and Cysts Under Ultrasound Control

Smyła¹,

Zaniewski²,

Piekorz³

et al. 2007

Polish Journal of Surgery

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The aim of the study was to determine the effectiveness and efficiency of drainage of pancreatic pseudocysts and cysts under ultrasound control during acute pancreatitis. Material and methods. During the period between 1985 and 2004, 103 patients were hospitalized at The Department of General and Vascular Surgery, Regional Specialistic Hospital in Tychy, due to pancreatic pseudocysts or abscesses. Pancreatic abscesses were observed in 36 patients, while the remaining 67 patients were diagnosed with pseudocysts. Percutaneous drainage was indicated to treat pancreatic liquid cisterns when the cistern exceeded 4-6 cm in diameter, and had no tendency towards idiopathic absorption. Drainage procedures were performed in the operating room with the use of a 3,5MHz linear probe and "Cavafix" CH 18, "Nephrofix" 10-15 or "Cystofix" 10-15 kits. Results. Recovery following percutaneous drainage was obtained in 33 of 36 (91,7%) patients with pancreatic pseudocysts, and in 60 of 67 (89,5%) patients with pancreatic abscesses. The average duration of the drainage amounted to 19.25 days in case of peudocysts and 30.2 days in case of abscesses. Six patients with pseudocysts and three with abscesses required surgical intervention due to inefficient inefficiency drainage. Pseudocyst infections were the most common complications observed following drainage and were seen in 12 (17.9%) patients. Conclusions. In selected cases, drainage of pancreatic pseudocysts and cysts under ultrasound control may be an alternative to surgery. This method is highly recommended as it is less invasive, improves the patient's life comfort and reduces treatment costs.

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Percutaneous Drainage for Treatment of Infected Pancreatic Pseudocysts

Abstract: Our findings indicate that PCD is a safe and effective front-line treatment for patients with infected pancreatic pseudocysts.

Cited by 29 publications

References 14 publications

Clinical practice guideline: management of acute pancreatitis

Clinical practice guideline: management of acute pancreatitis

Successful Percutaneous Drainage with Iodine Irrigation for Pancreatic Fistulas and Abscesses after Necrotizing Pancreatitis

Drainage of Pancreatic Abscesses and Cysts Under Ultrasound Control

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