Drainage of pancreatic fluid collections in acute pancreatitis: A comprehensive overview

Abstract

Moderately severe and severe acute pancreatitis is characterized by local and systemic complications. Systemic complications predominate the early phase of acute pancreatitis while local complications are important in the late phase of the disease. Necrotic fluid collections represent the most important local complication. Drainage of these collections is indicated in the setting of infection, persistent or new onset organ failure, compressive or pressure symptoms, and intraabdominal hypertension. Percutaneous, endoscopic, and minimally invasive surgical drainage represents the various methods of drainage with each having its own advantages and disadvantages. These methods are often complementary. In this minireview, we discuss the indications, timing, and techniques of drainage of pancreatic fluid collections with focus on percutaneous catheter drainage. We also discuss the novel methods and techniques to improve the outcomes of percutaneous catheter drainage.

Association between acute peripancreatic fluid collections and early readmission in acute pancreatitis: A propensity-matched analysis

“…Our data show that both cohorts underwent a variety of endoscopic diagnostic and therapeutic procedures. Moreover, published literature describes the risk of late complications weeks after the intervention, specifically for peripancreatic fluid collections[ 58 , 59 ]. In our analysis, several procedures were also identified as 30-day readmission predictors in AP patients with APFC, including endoscopic retrograde cholangiography (no intervention), endoscopic dilation of the ampulla and biliary duct, and endoscopic stone removal from the biliary tract.…”

The state of the art in acute pancreatitis research

“…This approach is useful in specific cases such as pancreatic pseudocyst. Studies have shown that PCD can significantly reduce the inflammatory response, accelerate the recovery of normal CRP levels, and reduce the risk of multiple organ failure [26] and surgical debridement [27] . For severe AP patients, PFC can also reduce the treatment costs of patients [28] .…”

Application of Mini-Invasive Echo-Controlled Percutaneous Interventions in Patients With a Complicated Course of Acute Pancreatitis

“…Відповідно до міжнародних лікувально-діаностичних протоколів ведення хворих на ГП, етапний підхід у лікування захворювання є патогенетично обгрунтованим. Загальновизнаною альтернативою традиційним оперативним втручанням є застосування мініінвазивних пункційних дренуючих втручань на першому етапі лікування, при цьому ефективність черезшкірних методик складає 18-53% [7,8]. Проведений аналіз результатів застосування мініінвазивних черезшкірних ехо-контрольованих оперативних втручань показав, що впровадження у хворих основної групи удосконалених нами методик розширило можливості їх використання, у тому числі при локалізації інфікованих локальних ускладнень за правим та центрально-правим типом та вірогідно підвищило їх ефективність по відношенню до групи порівняння на 41,8% (χ2=4,84, 95% ДІ 5,37-64,13, p=0,02).…”