Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India.
Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India.
J Vasc Interv Radiol. 2021 Nov;32(11):1591-1600.e1. doi: 10.1016/j.jvir.2021.08.004. Epub 2021 Aug 17.
To evaluate and compare the immediate and long-term outcomes of radiological interventions for hemorrhagic complications in patients with acute and chronic pancreatitis.
This retrospective study, conducted between January 2014 and June 2020, included all patients with acute and chronic pancreatitis presenting with hemorrhagic complications who underwent angiography and/or embolization. Their clinical, angiographic, and embolization details were evaluated and correlated with procedure success, complications, recurrence, and mortality. The patients were subgrouped into groups A (acute pancreatitis) and C (chronic pancreatitis), and comparisons were made.
The study included 141 patients (mean age, 36.3 ± 11.2 years; 124 men), of whom 106 patients had abnormal angiography findings and underwent embolization. Of them, group A had 50 patients (56 lesions) and group C had 56 patients (61 lesions). All the patients in group A had severe acute pancreatitis, with a mean computed tomography severity index of 7.6. The technical and clinical success rates of embolization, complications, recurrence, and long-term outcomes were not significantly different between the groups. Group A had significantly higher mortality due to sepsis and organ failure. Embolic agents did not have any significant association with complications, recurrence, and mortality. After a mean follow-up of 2 years, 72.5% of the patients were asymptomatic, and none had symptoms attributable to embolization.
Success, complications, and recurrence after embolization for hemorrhagic complications were comparable between acute and chronic pancreatitis. Acute pancreatitis was associated with significantly higher mortality. Embolic agents did not significantly influence the outcomes. None had long-term adverse effects attributable to embolization.
评估和比较急性和慢性胰腺炎出血并发症患者的放射介入即时和长期疗效。
本回顾性研究纳入了 2014 年 1 月至 2020 年 6 月间所有因出血并发症而行血管造影和/或栓塞术的急性和慢性胰腺炎患者。评估其临床、血管造影和栓塞细节，并与手术成功率、并发症、复发和死亡率相关联。患者分为 A 组（急性胰腺炎）和 C 组（慢性胰腺炎），并进行比较。
共纳入 141 例患者（平均年龄 36.3 ± 11.2 岁，124 例男性），其中 106 例患者存在异常血管造影表现并接受了栓塞治疗。A 组有 50 例患者（56 个病灶），C 组有 56 例患者（61 个病灶）。A 组所有患者均为重症急性胰腺炎，CT 严重指数平均为 7.6。栓塞的技术和临床成功率、并发症、复发和长期疗效在两组间无显著差异。A 组因感染性休克和多器官功能衰竭导致死亡率显著升高。栓塞剂与并发症、复发和死亡率之间无显著相关性。平均随访 2 年后，72.5%的患者无症状，且无患者因栓塞出现症状。
急性和慢性胰腺炎出血并发症栓塞治疗的成功率、并发症和复发率相当。急性胰腺炎与更高的死亡率相关。栓塞剂对结果无显著影响。无长期不良栓塞相关效应。
