Evidence map›Paper›PMID 25631111›Full record

ArticleSurgical endoscopy2015

A percutaneous drainage protocol for severe and moderately severe acute pancreatitis.

Motokazu Sugimoto, David P Sonntag, Greggory S Flint, Cody J Boyce, John C Kirkham, Tyler J Harris, Sean M Carr, Brent D Nelson, Joshua G Barton, L William Traverso

Abstract readEvaluation Study
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Motokazu SugimotoCenter for Pancreatic and Liver Disease, St. Luke's Health System, 100 East Idaho Street, Suite 301, Boise, ID, 83712, USA. msugimot7@gmail.com.
David P SonntagDepartment of Interventional Radiology, St. Luke's Health System, 100 East Idaho Street, Suite 301, Boise, ID, 83712, USA.
Greggory S FlintCenter for Pancreatic and Liver Disease, St. Luke's Health System, 100 East Idaho Street, Suite 301, Boise, ID, 83712, USA.
Cody J BoyceDepartment of Diagnostic Radiology, St. Luke's Health System, 100 East Idaho Street, Suite 301, Boise, ID, 83712, USA.
John C KirkhamDepartment of Diagnostic Radiology, St. Luke's Health System, 100 East Idaho Street, Suite 301, Boise, ID, 83712, USA.
Tyler J HarrisDepartment of Interventional Radiology, St. Luke's Health System, 100 East Idaho Street, Suite 301, Boise, ID, 83712, USA.
Sean M CarrDepartment of Interventional Radiology, St. Luke's Health System, 100 East Idaho Street, Suite 301, Boise, ID, 83712, USA.
Brent D NelsonDepartment of Interventional Radiology, St. Luke's Health System, 100 East Idaho Street, Suite 301, Boise, ID, 83712, USA.
Joshua G BartonCenter for Pancreatic and Liver Disease, St. Luke's Health System, 100 East Idaho Street, Suite 301, Boise, ID, 83712, USA.
L William TraversoCenter for Pancreatic and Liver Disease, St. Luke's Health System, 100 East Idaho Street, Suite 301, Boise, ID, 83712, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAccording to the revised Atlanta classification, severe and moderately severe acute pancreatitis (AP) includes patients with pancreatic and peripancreatic collections with or without organ failure. These collections suggest the presence of pancreatic juice leakage. The aim of this study was to evaluate the efficacy of a percutaneous catheter drainage (PCD) protocol designed to control leakage and decrease disease severity.

methodsAmong 663 patients with clinical AP, 122 were classified as moderately severe or severe AP (all had collections). The computed tomography severity index (CTSI) score was calculated. The indication for PCD was based on progressive clinical signs and symptoms. Drain patency, position, and need for additional drainage sites were assessed using CT scans and drain studies initially every 3 days using a proactive protocol. Drain fluid was examined for amylase concentration and microbiological culture. Clinicopathological variables for patients with and without PCD were compared. Since there was no mortality, we used prolonged drainage time to measure the success of PCD. Within the group treated with PCD, variables that resulted in prolonged drainage time were analyzed.

resultsPCD was used in 47/122 (39 %) patients of which 33/47 (70 %) had necrosis. PCD cases had a median CTSI of 8 and were classified as moderately severe AP (57 %) and severe AP (43 %). Inhospital mortality was zero. Surgical necrosectomy was not required for patients with necrosis. Independent risk factors for prolonged drainage time were persistent organ failure >48 h (P = 0.001), CTSI 8-10 (P = 0.038), prolonged duration of amylase-rich fluid in drains (P < 0.001), and polymicrobial culture fluid in drains (P = 0.015).

conclusionsA proactive PCD protocol persistently maintaining drain patency advanced to the site of leak controlled the prolonged amylase in drainage fluid resulting in a mortality rate of zero.

Indexed as

Acute DiseaseAdultAgedAged, 80 and overDrainageFemaleHumansMaleMiddle AgedNecrosisPancreatitisRetrospective StudiesSeverity of Illness IndexTreatment OutcomeDrainageNecrosisPancreatic fistulaPancreatic juicePancreatitisTreatment outcome

Identifiers

PMID25631111

What OpenQuestion holds

Textmetadata
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.