Alternative treatment modalities of infected pancreatic necrosis.

作者：Attila Oláh, Tibor Belágyi, Péter Bartek, László Pohárnok, László Romics · 发表于：PubMed · 年份：2006 · 被引用次数：24 · 研究领域：Pancreatitis Pathology and Treatment、Pancreatic and Hepatic Oncology Research、Dermatological and COVID-19 studies

BACKGROUND/AIMS: Infected pancreatic necrosis diagnosed by fine needle aspiration (FNA) is generally considered an indication for surgery. Percutaneous drainage can postpone surgical intervention and in some cases can even have a therapeutic effect. Furthermore, targeted antibiotic therapy alone, based on bacterial cultures from FNA, can result in a full recovery. A retrospective analysis was carried out on the various treatment modalities of infected pancreatic necrosis. METHODOLOGY: Eighty patients with infected pancreatic necrosis were treated in the Department of Surgery, Teaching County Hospital, Györ, Hungary between 1998 and 2003. Seventy-four patients required surgical intervention, 12 of which underwent prior ultrasound or CT-guided drainage. RESULTS: In patients with previous percutaneous drainage the average time to first surgical intervention was 30 days (n=12). However, in those patients who did not undergo percutaneous drainage the time to initial surgical intervention was 15.6 days. This was statistically significant (p = 0.001). There was a full recovery in 3 out of the 15 patients, who underwent percutaneous drainage. This figure of 20% corresponds with that in the published literature. Three of the total 80 patients studied made a complete recovery when treated with targeted antibiotic therapy alone and did not require further radiological or surgical intervention. CONCLUSIONS: Our data indicate that percutaneous drainage can postpone surgical intervention. ...