ArticleJournal of the West African College of Surgeons
Role of Early Percutaneous Drainage of Symptomatic Acute Fluid Collections in Moderately Severe and Severe Acute Pancreatitis: A Randomised Study.
Article in Journal of the West African College of Surgeons. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
Objective: The step-up approach for severe acute pancreatitis (SAP) has gained considerable traction. However, there is no consensus on percutaneous drainage (PCD) of early (<4 weeks) acute fluid collections (AFCs), some of which may produce mass effects and worsening inflammation. We designed a prospective randomised study to determine the role of PCD in symptomatic AFCs in SAP. Materials and Methods: Our prospective randomised study divided patients of moderately SAP (MSAP) and SAP with symptomatic (mass effect, fever, anorexia, and poor organ scores) AFCs into two groups:- Group 1 for conservative management (CM) and Group 2 for PCD. Requisite ethics and scientific clearances were obtained. The primary outcome variable was hospital stay; some other recorded variables included mortality, organ scores, sequential organ failure assessment (SOFA), and intra-abdominal pressure (IAP). Results: Of 78 patients with acute pancreatitis in 18 months, 38 (49%) fulfilled the inclusion criteria. Group 1 or CM had 20, and Group 2 or PCD had 18 patients; 16 from each group were eventually compared. No significant differences were observed in any clinical or outcome parameter except better day 7 SOFA scores and IAP in Group 2 (SOFA: 1.69 ± 1.55 vs. 3.33 ± 1.35, Conclusion: PCD in appropriately selected patients of MSAP and SAP with AFCs can hasten recovery, slow down organ damage, and decrease IAP significantly. More studies with a larger sample are needed in this area.
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