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Outcome of percutaneous drainage in patients with pancreatic necrosis having organ failure

Authors :
Anupam Kumar Singh
Vikas Gupta
Rakesh Kochhar
Pankaj Gupta
Ajay Gulati
Anmol Bhatia
Saroj K. Sinha
Vikas Gautam
Jayanta Samanta
Thakur Deen Yadav
Source :
HPB. 23:1030-1038
Publication Year :
2021
Publisher :
Elsevier BV, 2021.

Abstract

Percutaneous catheter drainage (PCD) is an effective way of drainage in acute pancreatitis (AP) and its role in persistent organ failure (OF) has not been studied. This study assessed the outcome of severe AP managed with PCD.We retrospectively analysed outcome of AP patients undergoing PCD for persistent OF with respect to success of PCD, etiology, severity scores, OF, imaging features and PCD parameters. Success of PCD was defined as resolution of with PCD and survived without surgical necrosectomy.Between January 2016 and May 2018, 83 patients underwent PCD for persistent OF at a mean duration of 25.59 ± 21.2 days from pain onset with successful outcome in 47 (56.6%) patients. Among PCD failures, eleven (13.25%) patients underwent surgery. Overall mortality was 31 (37.3%). On multivariate analysis, pancreatic necrosis50% and absence of extrapancreatic infection (EPI) predicted the success of PCD. Presence of infected necrosis did not affect the outcome of PCD in organ failure.PCD improves the outcome in patients with OF even when done early irrespective of the status of infection of necrosis. Therefore, PCD may be considered early in the course of patients with OF.

Details

ISSN :
1365182X
Volume :
23
Database :
OpenAIRE
Journal :
HPB
Accession number :
edsair.doi.dedup.....e616e3b9c154f02e628212e13f8f6155
Full Text :
https://doi.org/10.1016/j.hpb.2020.10.021