Document Detail


Percutaneous catheter-directed debridement of infected pancreatic necrosis: results in 20 patients.
MedLine Citation:
PMID:  9684824     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate the usefulness of transcatheter debridement of infected pancreatic necrosis. MATERIALS AND METHODS: Transcatheter debridement was performed on 20 patients who ranged in age from 20 to 78 years during the 8-year study period. All patients had infected pancreatic necrosis and were hemodynamically stable. Necrosis was defined as nonenhancing pancreatic tissue, as seen on contrast-enhanced computed tomography (CT). Infection was suspected clinically and documented by cultures of the pancreatic fluid at its initial drainage. Debridement was performed in multiple sessions in close succession (duration, 30-120 minutes; mean, 60 minutes) via large-bore catheters with enlarged side holes. Debris was removed with use of suction catheters, stone baskets, and copious amounts of lavage fluid. RESULTS: All patients underwent successful catheter debridement. Success was determined by clinical course, as well as lesion appearance, at fluoroscopy and CT. Patients underwent 7-32 (average, 17) episodes of debridement and stayed 0-36 days (average, 9 days) in the intensive care unit, 13-118 days (average, 42 days) on the regular floor, and spent 0-98 days (average, 32 days) with the catheters as an outpatient. No deaths occurred. CONCLUSION: Percutaneous catheter-directed debridement is a safe and effective treatment and it can be used as the primary means of treatment for the hemodynamically stable patient with infected pancreatic necrosis.
Authors:
A M Echenique; D Sleeman; J Yrizarry; T Scagnelli; J J Guerra; V J Casillas; H Huson; E Russell
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of vascular and interventional radiology : JVIR     Volume:  9     ISSN:  1051-0443     ISO Abbreviation:  J Vasc Interv Radiol     Publication Date:    1998 Jul-Aug
Date Detail:
Created Date:  1998-10-15     Completed Date:  1998-10-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  565-71     Citation Subset:  IM    
Affiliation:
Department of Radiology, University of Miami School of Medicine, Jackson Memorial Hospital, FL 33136, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antibiotic Prophylaxis
Bacterial Infections / radiography,  surgery*
Catheterization / instrumentation*
Debridement / instrumentation*
Equipment Design
Female
Follow-Up Studies
Humans
Male
Middle Aged
Pancreatitis, Acute Necrotizing / radiography,  surgery*
Postoperative Complications / radiography,  therapy
Reoperation
Suction / instrumentation*
Tomography, X-Ray Computed / instrumentation*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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