Abdominal Paracentesis Drainage Does Not Increase Infection in Severe Acute Pancreatitis

Abstract

To demonstrate the relationship between abdominal paracentesis drainage (APD) and infectious complications in moderately severe acute pancreatitis (MSAP) or severe acute pancreatitis (SAP) patients. The effectiveness of APD for SAP was demonstrated in our previous study. However, the relationship between APD and infectious complications has not been fully elucidated. We conducted a prospective cohort study of 255 patients with MSAP or SAP. The patients were divided into 2 groups: patients with acute pancreatitis who underwent APD (group 1) and patients with acute pancreatitis who did not undergo APD (group 2). Four types of infectious complications were evaluated: bacteremia, infected necrosis, pneumonia, and sepsis. The pathogens responsible for infectious complications were analyzed. The need for percutaneous catheter drainage and mortality were also compared between the 2 groups. A total of 255 patients were included with analogous baseline features. The rate of overall infectious complications in group 1 was 38.1%, which was lower than that in group 2 (52.7%, P=0.019). This difference was mainly based on infected necrosis (12.7% and 23.3% in groups 1 and 2, respectively, P=0.034). The microbial spectrum was similar in the 2 groups. Percutaneous catheter drainage was used less frequent in group 1 (18.3%) than in group 2 (31.8%, P=0.014). The infection-related mortality in groups 1 and 2 was 6.5% and 8.5%, respectively, and there was no significant difference (P=0.457). Our results indicate that APD did not increase the infectious complications and infection-related mortality compared with the strategy without APD in patients with MSAP or SAP.