[Diagnostic and therapeutic usefulness of interventional ultrasound in pancreatic pseudocysts and abscesses].

The purpose of the presented study was the assessment of diagnostic and therapeutic efficacy of percutaneous drainage of pancreatic pseudocysts and abscesses, guided by ultrasound (US). The study population comprised 65 patients, aged 21-79 years: in 18 of them pancreatic abscess and in remaining 47--pancreatic pseudocyst were diagnosed. Causes of the fluid accumulation were: acute pancreatitis--in 57, trauma--in 3 and in 5 the specific etiological factor was not found. Ultrasound was performed with Aloka Hellige SSD 280-LS scanner and Braun Melsungen Nephrofix and Cystofix kits were used for drainage. Enzymatic, bacteriologic and cytologic examination of aspirate was performed. Duration of catheter drainage in pseudocysts was 10-40 days (mean 18) and from abscesses--21-56 days (mean 32). A variety of organisms was cultured from pancreatic fluid, Escherichia coli being most prevalent, also Proteus, Staphylococcus, aureus etc were found. Definite cure was obtained in 54 (83%) patients, among them in 40 (85.1%) with pseudocysts and in 14 (77.7%) with abscesses, which was confirmed in control imaging examinations (US and/or CT) after 4-6 months after catheter was removed. In 10 (15.38%) cases surgical intervention appeared necessary--in 7 patients during unsuccessful drainage and in 3--because of late recurrence. One patient died after relaparotomy. Percutaneous drainage is effective in the treatment of pancreatic fluid collections, allowing in most cases avoiding surgical intervention and providing additional diagnostic data.