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

Zerem, Enver; Omerović, Safet

doi:10.1159/000336594

Cited by 6 publications

(1 citation statement)

References 17 publications

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“…Case reports have also described instillation of amphotericin B for a fungal infection of pancreatic collection and use of iodine irrigation in an infected collection. 39,40 The use of streptokinase has also been attempted in order to liquefy and achieve a better drainage of the pancreatic collections, and it was suggested that in comparison to saline treated collections, streptokinase helped in fragmenting the necrosum and changing it's consistency. Surgery could be avoided in the two patients where streptokinase was used.…”

Section: Modifications In Percutaneous Drainage To Improve Outcome Lomentioning

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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Section: Modifications In Percutaneous Drainage To Improve Outcome Lomentioning

confidence: 99%