Efficacy of sterile percutaneous catheter drainage in acute pancreatitis of various severities associated with acute inflammatory pancreatic fluid collection

Abstract

Introduction: To evaluate the efficacy of early-stage sterile percutaneous catheter drainage (sPCD) of drainable acute inflammatory pancreatic fluid collections (AIPFCs) in acute pancreatitis (AP) of different severities. A retrospective analysis was performed based on the presence of drainable AIPFCs and different AP severity classifications. Methods: 162 patients with drainable AIPFCs were classified as severe acute pancreatitis (SAP) per the 1992 Atlanta classification (SAP-1992AC). Of these, 94 patients with persistent organ failure were reclassified as SAP according to the 2012 Revised Atlanta classification (SAP-2012RAC); whereas, 68 patients with transient organ failure and/or local complications were reclassified as having moderate severity acute pancreatitis (MSAP-2012RAC). Early-stage sPCD was performed among 64 SAP-2012RAC and 41 MSAP-2012RAC. Outcome variables including operation rate (OR), pancreatic infection rate (IR), and mortality was compared between patients with and without sPCD. Results: 2012RAC divides the SAP-1992AC patients into two groups: SAP-2012RAC and MSAP-2012RAC patients. The Early-stage sPCD caused no change in outcome variables among SAP-1992AC-classified patients with AIPFCs, but cause obvious decreases in the OR (P = 0.006), IR (P = 0.020), and mortality (P = 0.009) in SAP-2012RAC patients. In MSAP-2012RAC patients, however, sPCD was associated with an increased OR (P = 0.009) and IR (P = 0.040). Conclusions: In virtue of 2012RAC, we can conclude that early-stage sPCD improve the prognosis in SAP-2012RAC patients with drainable AIPFCs by reducing the OR, IR, and mortality, but did not do so in MSAP-2012RAC patients.