Kissing catheter technique for percutaneous catheter drainage of necrotic pancreatic collections in acute pancreatitis

Gupta, Pankaj; Koshi, Suzanne; Samanta, Jayanta; Mandavdhare, Harshal; Sharma, Vishal; Sinha, Saroj Kant; Dutta, Usha; Kochhar, Rakesh

doi:10.3892/etm.2020.8897

Cited by 9 publications

(7 citation statements)

References 25 publications

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“…This information, in turn, will allow early intervention aimed at reducing IAP in the high-risk group. 31 32 However, prospective studies with larger patient cohorts will validate these findings.…”

Section: Discussionmentioning

confidence: 94%

Computed Tomography Findings in Intraabdominal Hypertension in Patients with Acute Pancreatitis

Gupta

Kamat

Samanta

et al. 2021

Indian Journal of Radiology and Imaging

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Purpose Intraabdominal hypertension (IAH) in acute pancreatitis (AP) may reduce tissue perfusion and impair organ function and has been shown to portend poor prognosis. We investigated the computed tomography (CT) findings in patients with AP with IAH. Methods This retrospective study comprised of consecutive patients with AP from June 2016 to June 2018 in whom intraabdominal pressure (IAP) was measured. The patients who underwent a contrast-enhanced CT within 7 days of IAP measurement were included. Using a cutoff of 12 mm Hg for IAP, the patients were divided into IAH and non-IAH groups. Measures of severity and clinical outcome were evaluated. CT parameters were compared between the groups. Results The IAH group comprised of 41 patients, while there were 20 patients in the non-IAH group. The IAH group was characterized by severe disease, increased incidence of organ failure, increased requirement for drainage and surgery, prolonged hospital and intensive care unit stay. The mortality was not significantly different between the two groups. On univariate analysis, the CT features that were found to be significantly different between the two groups were the presence of collection (p = 0.036), the maximum dimension of collection (p = 0.004), volume of collection (p = 0.019), biliary dilatation (p = 0.011), and the presence of moderate-to-severe pleural effusion (p = 0.009). On multivariate analysis, all these parameters except biliary dilatation were found to be statistically significant. Conclusion CT findings in patients with AP may suggest IAH. This can be used as an additional marker for severity of AP.

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Section: Discussionmentioning

confidence: 94%

Computed Tomography Findings in Intraabdominal Hypertension in Patients with Acute Pancreatitis

Gupta

Kamat

Samanta

et al. 2021

Indian Journal of Radiology and Imaging

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“…The final catheter size may be as large as 30 to 48 Fr depending on the response of the patient to initial drainage. 72 In a retrospective study by Bruennler et al there was no impact of initial catheter size on the mortality of patients with infected pancreatic necrosis. 73 A recent study showed that large sized catheters are associated with better outcomes.…”

Section: Summary Of the Evidencementioning

confidence: 94%

Indian College of Radiology and Imaging Consensus Guidelines on Interventions in Pancreatitis

Gupta

Madhusudhan

Padmanabhan

et al. 2022

Indian J Radiol Imaging

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Acute pancreatitis (AP) is one of the common gastrointestinal conditions presenting as medical emergency. Clinically, the severity of AP ranges from mild to severe. Mild AP has a favorable outcome. Patients with moderately severe and severe AP, on the other hand, require hospitalization and considerable utilization of health care resources. These patients require a multidisciplinary management. Pancreatic fluid collections (PFCs) and arterial bleeding are the most important local complications of pancreatitis. PFCs may require drainage when infected or symptomatic. PFCs are drained endoscopically or percutaneously, based on the timing and the location of collection. Both the techniques are complementary, and many patients may undergo dual modality treatment. Percutaneous catheter drainage (PCD) remains the most extensively utilized method for drainage in patients with AP and necrotic PFCs. Besides being effective as a standalone treatment in a significant proportion of these patients, PCD also provides an access for percutaneous endoscopic necrosectomy and minimally invasive necrosectomy. Endovascular embolization is the mainstay of management of arterial complications in patients with AP and chronic pancreatitis. The purpose of the present guideline is to provide evidence-based recommendations for the percutaneous management of complications of pancreatitis.

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“…This technique involves placement of two catheters side by side through the same puncture site into the collection after serial dilatation of the tract[ 32 ]. The kissing catheters were deployed only when patients failed to respond to serial upgradations of a single catheter or mean CT density of the collection was > 30 HU, and the purpose of the kissing catheters was to provide one catheter for flushing and another for aspiration.…”

Section: Technical Innovationsmentioning

confidence: 99%

“…Flushing, aspiration, and/or upsizing were done till there was no residual collection left. With this technique, eight out of ten treated patients did not require a surgical necrosectomy[ 32 ].…”

Section: Technical Innovationsmentioning

confidence: 99%

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

Bansal¹,

Gupta²,

Singh³

et al. 2022

WJCC

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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.

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Kissing catheter technique for percutaneous catheter drainage of necrotic pancreatic collections in acute pancreatitis

Cited by 9 publications

References 25 publications

Computed Tomography Findings in Intraabdominal Hypertension in Patients with Acute Pancreatitis

Computed Tomography Findings in Intraabdominal Hypertension in Patients with Acute Pancreatitis

Indian College of Radiology and Imaging Consensus Guidelines on Interventions in Pancreatitis

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

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