CT-Guided Percutaneous Catheter Drainage of Acute Necrotizing Pancreatitis: Clinical Experience and Observations in Patients with Sterile and Infected Necrosis

Abstract

OBJECTIVE. The purpose of this study was to report on clinical experience with and observations made during primary CT-guided percutaneous catheter drainage of acute necrotizing pancreatitis and to compare results among patients with sterile and those with infected necrosis.MATERIALS AND METHODS. We reviewed clinical, radiologic, and bacteriologic data on 35 patients (23 men, 12 women; mean age, 50 years; range, 21-83 years) with acute necrotizing pancreatitis refractory to standard medical care who underwent CT-guided percutaneous catheter drainage with 12- to 22-French catheters. Experiences with two subgroups were compared. One group consisted of 22 patients, 10 with multisystem organ failure, who presented with sterile necrosis (median Atlanta score, 1.3; range, 0-3). The other group consisted of 13 patients, one with multisystem organ failure, who presented with infected necrosis (median Atlanta score, 0.4; range, 0-3). Differences between the group with sterile and the group with infected necrosis w...