Persistent Pancreatocutaneous Fistula after Percutaneous Drainage of Pancreatic Fluid Collections: Role of Cause and Severity of Pancreatitis

Abstract

Development of PPCF correlated with severity of pancreatitis, regardless of the cause of pancreatitis.

Percutaneous Catheter Drainage in Infected Pancreatitis Necrosis: a Systematic Review

“…Diagnosis was the presence of gas in the peripancreatic collection on CT or a positive culture at fineneedle aspiration. The etiology of infected pancreatitis necrosis was reported in 9 studies [8,16,17,25,27,28,[33][34][35], in which the most common cause was biliary tract disease. APACHE II scores and CT severity index scores were used in the 10 studies [8,16,17,28,29,31,[33][34][35][36]; 0.195 (55.3 %) of 352 patients had organ failure before PCD in 9 studies (including single and multiple organ failure) [8,17,29,30,[32][33][34][35][36].…”

“…Seven studies reported the mean length of hospital stay [16,[27][28][29][31][32][33], which ranged from 3 to 241 days. Eight studies reported the mean length of initial treatment with PCD after hospital admission [8,16,17,25,28,29,32,35]. The success rate of PCD, defined as the recovery of patients without additional surgical intervention, was 56.2 % (324 of 577 patients).…”

“…The complication rate was described in 11 series [8,16,25,26,28,33,36], 96 of 382 patients (25.1 %) had reported complications. The majority of complication was fistulas (43; 44.8 % of 96 patients), one study described severe clinical complications (24; 71 % of 34 patients) [16], including respiratory and renal failure.…”

“…Of the total 15 articles, 12 studies reported the size of catheters, which ranged from 6 to 32 French [16,17,[25][26][27][28][29][31][32][33][34][35]. Moreover, most of the radiological interventions were CT guided.…”

“…Five studies showed that the large bore (>20 F) was the final size of the catheter achieved after up-sizing the initial small bore catheters [16,17,29,31,32]. On the other side, two studies considered the catheters were selected on the basis of the characteristics of the fluid [25,33]. One study deemed that the viscous fluid and fluid that contained particles should be drained by using large catheters while low-viscosity fluid should be drained by using small bore catheters [25].…”