A modified method for percutaneous drainage of acute necrotic collections in patients with infected pancreatic necrosis

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OBJECTIVE

To develop a modified method for percutaneous drainage of acute necrotic collections in patients with infected pancreatic necrosis.

MATERIALS AND METHODS

Minimally invasive surgical technologies were used in 74 patients with infected acute necrotic collections at the Krasnodar Regional Clinical Hospital No. 2 between 2017 and 2019. Of these, 59 (79.7%) people underwent percutaneous drainage as a final treatment. In 11 (14.9%) patients, video sequestrectomy through the fistula was additionally used to increase efficiency of percutaneous drainage.

RESULTS

PCD in our modification implies delivery of double-lumen drains 26-32 Fr in the same plane to zones of necrosis, their programmed replacement for prevention of obstruction and flexible endoscopy for control of pathological process. Local purulent-necrotic parapancreatitis occurred in 31 (41.9%) patients, widespread parapancreatitis — in 43 (58.1%) patients. There were 339 minimally invasive interventions. Laparotomy was required in 4 (5.4%) patients. Incidence of perioperative complications was 10.6%, mortality — 16.2%.

CONCLUSION

A modified percutaneous drainage method may be used as final surgical treatment in 79.7% of patients with infected pancreatic necrosis.

Keywords:

pancreas

infected pancreatic necrosis

minimally invasive interventions

acute necrotic collections

percutaneous catheter drainage

Authors:

Remizov S.I.

Regional Clinical Hospital No. 2;
Kuban State Medical University

ORCID: 0000-0001-9410-9493

Andreev A.V.

Regional Clinical Hospital No. 2;
Kuban State Medical University

ORCID: 0000-0003-0945-9400

Durleshter V.M.

Regional Clinical Hospital No. 2;
Kuban State Medical University

ORCID: 0000-0002-7420-0553

Gabriel S.A.

Regional Clinical Hospital No. 2;
Kuban State Medical University

ORCID: 0000-0002-0755-903X

Zasyadko O.V.

Kuban State Medical University

ORCID: 0000-0003-0625-0791

Received:

12.04.2023

Accepted:

09.05.2023

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