Systematic review of percutaneous catheter drainage as primary treatment for necrotizing pancreatitis

被引:234
作者
van Baal, M. C. [2 ]
van Santvoort, H. C. [2 ]
Bollen, T. L. [3 ]
Bakker, O. J. [2 ]
Besselink, M. G. [2 ]
Gooszen, H. G. [1 ]
机构
[1] Radboud Univ Nijmegen, Med Ctr, Dept Operat Room Evidence Based Surg, NL-6500 MB Nijmegen, Netherlands
[2] Univ Med Ctr Utrecht, Dept Surg, Utrecht, Netherlands
[3] St Antonius Hosp, Dept Radiol, Nieuwegein, Netherlands
关键词
TERM-FOLLOW-UP; FLUID COLLECTIONS; SURGICAL-MANAGEMENT; NECROSECTOMY; NECROSIS; CT; MORTALITY; DEBRIDEMENT; SEVERITY; STERILE;
D O I
10.1002/bjs.7304
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: The role of percutaneous catheter drainage (PCD) in patients with (infected) necrotizing pancreatitis was evaluated. Methods: A systematic literature search was performed.Inclusion criteria were: consecutive cohort of patients with necrotizing pancreatitis undergoing PCD as primary treatment for peripancreatic collections; indication for PCD either (suspected) infected necrosis or symptomatic sterile pancreatic necrosis; and outcomes reported to include percentage of infected peripancreatic collections, need for additional surgical necrosectomy, complications and deaths.Exclusion criteria were: cohort of fewer than five patients; cohort included patients with chronic pancreatitis; selected subgroup of patients with acute pancreatitis studied, such as those with pseudocysts, pancreatic abscesses and/or exclusively sterile pancreatic necrosis; and cohort in which PCD was combined with another minimally invasive strategy and results for PCD alone not reported separately. Results: Eleven studies, including 384 patients, fulfilled the inclusion criteria.Only one study was a randomized controlled trial; most others were retrospective case series.Four studies reported on the presence of organ failure before PCD; this occurred in 67.2 per cent of 116 patients.Infected necrosis was proven in 271 (70.6 per cent) of 384 patients.No additional surgical necrosectomy was required after PCD in 214 (55.7 per cent) of 384 patients.Complications consisted mostly of internal and external pancreatic fistulas.The overall mortality rate was 17.4 per cent (67 of 384 patients).Nine of 11 studies reported mortality separately for patients with infected necrosis undergoing PCD; the mortality rate in this group was 15.4 per cent (27 of 175). Conclusion: A considerable number of patients can be treated with PCD without the need for surgical necrosectomy.
引用
收藏
页码:18 / 27
页数:10
相关论文
共 70 条
[51]   Minimal Access Retroperitoneal Pancreatic Necrosectomy Improvement in Morbidity and Mortality With a Less Invasive Approach [J].
Raraty, Michael G. T. ;
Halloran, Christopher M. ;
Dodd, Susanna ;
Ghaneh, Paula ;
Connor, Saxon ;
Evans, Jonathan ;
Sutton, Robert ;
Neoptolemos, John P. .
ANNALS OF SURGERY, 2010, 251 (05) :787-793
[52]   Surgical treatment of necrotizing pancreatitis by necrosectomy and closed lavage: Changing patient characteristics and outcome in a 19-year, single-center series [J].
Rau, B ;
Bothe, A ;
Beger, HG .
SURGERY, 2005, 138 (01) :28-39
[53]   Impact of Radiologic Intervention on Mortality in Necrotizing Pancreatitis The Role of Organ Failure [J].
Rocha, Flavio G. ;
Benoit, Eric ;
Zinner, Michael J. ;
Whang, Edward E. ;
Banks, Peter A. ;
Ashley, Stanley W. ;
Mortele, Koenraad J. .
ARCHIVES OF SURGERY, 2009, 144 (03) :261-265
[54]   Debridement and closed packing for sterile or infected necrotizing pancreatitis - Insights into indications and outcomes in 167 patients [J].
Rodriguez, J. Ruben ;
Razo, A. Swaldo ;
Targarona, Javier ;
Thayer, Sarah P. ;
Rattner, David W. ;
Warshaw, Andrew L. ;
Castillo, Carlos Fernandez-del .
ANNALS OF SURGERY, 2008, 247 (02) :294-299
[55]   Combined endoscopic and percutaneous drainage of organized pancreatic necrosis [J].
Ross, Andrew ;
Gluck, Michael ;
Irani, Shayan ;
Hauptmann, Ellen ;
Fotoohi, Mehran ;
Siegal, Justin ;
Robinson, David ;
Crane, Robert ;
Kozarek, Richard .
GASTROINTESTINAL ENDOSCOPY, 2010, 71 (01) :79-84
[56]   Transluminal endoscopic necrosectomy after acute pancreatitis: a multicentre study with long-term follow-up (the GEPARD Study) [J].
Seifert, H. ;
Biermer, M. ;
Schmitt, W. ;
Juergensen, C. ;
Will, U. ;
Gerlach, R. ;
Kreitmair, C. ;
Meining, A. ;
Wehrmann, T. ;
Roesch, T. .
GUT, 2009, 58 (09) :1260-1266
[57]   Pancreatic abscess: 10 years experience [J].
Srikanth, G ;
Sikora, SS ;
Baijal, SS ;
Ayyagiri, A ;
Kumar, A ;
Saxena, R ;
Kapoor, VK .
ANZ JOURNAL OF SURGERY, 2002, 72 (12) :881-886
[58]  
Szentkereszty Z, 2002, HEPATO-GASTROENTEROL, V49, P1696
[59]  
Szentkereszty Z, 2008, HEPATO-GASTROENTEROL, V55, P266
[60]   INCIDENCE AND MANAGEMENT OF PANCREATIC AND ENTERIC FISTULAS AFTER SURGICAL-MANAGEMENT OF SEVERE NECROTIZING PANCREATITIS [J].
TSIOTOS, GG ;
SMITH, CD ;
SARR, MG .
ARCHIVES OF SURGERY, 1995, 130 (01) :48-52