Rey Carlos, Conde Danny, Girón Felipe, Ayala Daniela, Gonzalez Juliana, Melo Daniela, Quintero Marco
Universidad el Rosario, Colombia.
Hospital Universitario Mayor Méderi, Colombia.
Ann Med Surg (Lond). 2022 Jun 25;79:104080. doi: 10.1016/j.amsu.2022.104080. eCollection 2022 Jul.
Acute pancreatitis is one of the most common gastrointestinal diseases. Approximately 20% of the patients develop peripancreatic collections. Step-up management it's now the best approach with less rate of morbidity and mortality compared with open or minimally invasive surgery. Percutaneous management could reach a success rate between 50 and 76%. Our study shows the outcomes of -gastric versus transabdominal percutaneous drainage in cases of acute peripancreatic fluid infected collections in the absence of interventionist endoscopy.
A retrospective review of a prospectively collected database was conducted. All the patients older than 18 years old that underwent percutaneous drainage between January 2010-December 2021 were included. Analysis and description of outcomes such as mortality, complications, and avoidance of surgical procedures was performed.
18 patients underwent percutaneous drainage. 66.67% of patients were male. Mean age was 52.55 ± 22.06 years. Mean weight was 74.43 ± 15.25 kg. Mean size of peripancreatic collections 118.4 ± 49.12 mm. Wall-off necrosis was present in 33.33%. -gastric approach was performed in 50% of the cases, the rest was -abdominal. No mortality was evidenced after 30 days of follow up. After -gastric percutaneous drainage, all patients avoided surgical open or laparoscopic procedure.
Standardized step-up approach shows increased rates of success in percutaneous drainage of peripancreatic collections. Our case series shows a high rate of success in terms of avoidance any surgical procedure with no mortality after -abdominal and -gastric percutaneous drainage. Nevertheless, further prospective studies with higher sample size are needed.
急性胰腺炎是最常见的胃肠道疾病之一。约20%的患者会出现胰周积液。逐步治疗管理目前是最佳方法，与开放手术或微创手术相比，其发病率和死亡率更低。经皮治疗的成功率可达50%至76%。我们的研究显示了在没有介入性内镜检查的情况下，急性胰周感染性积液病例中行胃造口与经腹经皮引流的结果。
对前瞻性收集的数据库进行回顾性分析。纳入所有在2010年1月至2021年12月期间接受经皮引流的18岁以上患者。对死亡率、并发症和避免手术等结果进行分析和描述。
18例患者接受了经皮引流。66.67%的患者为男性。平均年龄为52.55±22.06岁。平均体重为74.43±15.25千克。胰周积液平均大小为118.4±49.12毫米。33.33%的患者存在包裹性坏死。50%的病例采用胃造口途径，其余采用经腹途径。随访30天后未发现死亡病例。经胃造口经皮引流后，所有患者均避免了开放或腹腔镜手术。
标准化的逐步治疗方法显示胰周积液经皮引流的成功率有所提高。我们的病例系列显示，经腹和经胃造口经皮引流后，在避免任何手术且无死亡方面成功率很高。然而，需要进一步进行样本量更大的前瞻性研究。
