Acton Holly J, Mulholland Douglas, Torreggiani William C
Trinity College Dublin, St James's Hospital, James's Street, Dublin 8, Ireland.
Department of Radiology, Beaumont Hospital, Beaumont Road, Dublin 9, Ireland.
Ir J Med Sci. 2019 Nov;188(4):1195-1200. doi: 10.1007/s11845-019-01970-4. Epub 2019 Feb 13.
Interventional radiology plays a central role in the management of complicated acute pancreatitis, contributing to image-guided drainages, treating haemorrhagic complications and maintaining the patency of the biliary tree. In addition, many of these patients require long-term venous access for antibiotics or parenteral feeding. The aim of this study was to evaluate the role and level of involvement of the interventional radiology in this sub-group of patients.
This was a single-centre retrospective review of all admissions for acute pancreatitis over a 5-year period. Each case was assessed to determine whether radiological intervention was utilised.
Our review included 401 patients. A total of 18.7% (75/401) of patients required vascular access procedures and 18.4% (74/401) required image-guided drainage. A total of 1.2% (2/401) patients had embolisation procedures performed. The embolisation procedures were performed to treat a pseudoaneurysm that had formed. Overall, 20.9% (84/401) of patients were referred to the interventional radiology department for a procedure; a majority of these patients were referred for multiple procedures over the course of their admission. The patients in the 'severe pancreatitis' category had a total of 154 procedures performed, which was 65.5% of the total procedures. On average, the patients who underwent multiple interventional procedures tended to have a longer admission and more complex disease.
The diagnosis and treatment of complicated acute pancreatitis is heavily dependent on the interventional radiology department. A substantial proportion of patients with pancreatitis required radiological intervention as part of their management, the proportion of which increased significantly in complex disease.
介入放射学在复杂急性胰腺炎的管理中发挥着核心作用，有助于影像引导下的引流、治疗出血性并发症以及维持胆道通畅。此外，这些患者中的许多人需要长期静脉通路以进行抗生素治疗或肠外营养。本研究的目的是评估介入放射学在这一亚组患者中的作用和参与程度。
这是一项对5年内所有急性胰腺炎入院病例的单中心回顾性研究。对每个病例进行评估，以确定是否采用了放射学干预措施。
我们的回顾纳入了401例患者。共有18.7%（75/401）的患者需要血管通路操作，18.4%（74/401）的患者需要影像引导下的引流。共有1.2%（2/401）的患者接受了栓塞术。栓塞术是为了治疗形成的假性动脉瘤。总体而言，20.9%（84/401）的患者因某项操作被转诊至介入放射科；这些患者中的大多数在住院期间被转诊进行多项操作。“重症胰腺炎”类别中的患者共接受了154项操作，占总操作数的65.5%。平均而言，接受多项介入操作的患者往往住院时间更长，病情更复杂。
复杂急性胰腺炎的诊断和治疗严重依赖介入放射科。相当一部分胰腺炎患者需要放射学干预作为其治疗的一部分，在复杂疾病中这一比例显著增加。
